By Loring Wirbel
When Amy Moore accepted the job as clinic director at the new Steven A. Cohen Military Family Clinic back in April, it didn’t yet physically exist. And as she assembled her team, she had to convince job applicants that the positions were real.
“Early in the hiring process, more than one person asked, ‘Is this position real? Is this some kind of joke?’” Moore recalls. “Of course, once we were far enough along in the interview, we could explain where we are and how the clinic was coming along.”
Moore drew on her personal experience as part of a military family, as well as professional stints at The Resource Exchange, AspenPointe, and Anthem to earn the position leading the clinic, which has been open since early November. It’s assembling clientele that include not only post-9/11 veterans and active duty service members, but military families as well.
Moore’s entire career to date has been centered on building effective alliances with community agencies that serve behavioral health needs, with the Cohen Veterans Network applying those resources to military families. CVN was established in the early 2000s with a focus on providing mental health support to veterans following the 9/11 terror attacks. The network of clinics since has expanded to cover active duty personnel through TriCare, and military families needing behavioral support.
Moore took the Business Journal on a tour through the nearly-finished clinic in early December, and shared her views on the future of veterans’ behavioral care.
You studied in Oklahoma, but where are you from?
My dad was in the Air Force and we moved around a lot until he retired when I was 11, and he chose Colorado as a great in-between place — between his family in Iowa and my mom’s family in California. I went to high school here, then went to college at Oral Roberts University in Tulsa, and lived in Oklahoma about six years. My initial major was in pastoral care, but I realized quickly I was interested in working in a mental health setting. My first job after college was in a community mental health center in Oklahoma called Family and Children’s Services. I worked in one of the most impoverished areas of the state, in North Tulsa where the race [massacre] happened, so this was a huge wakeup call. In order to figure out people’s mental health needs, you had to figure out what their needs in terms of social determinants of health would be, including jobs, housing, food security. Case management has always been close to my heart in providing services to people.
Was your goal always to return to Colorado?
It was — my parents are here. I always wanted to gain work experience before going to grad school. I came back in 2010 and attended UCCS, where I graduated in 2012 in their clinical counseling track. During that time I worked at The Resource Exchange as a resource coordinator for adults with developmental disabilities.
TRE has a broad mandate, working with schools and other organizations. Did it give you insight into how nonprofits and agencies here interact, and into issues like adult rights, host homes, respite homes?
Absolutely — especially with the waiver system (for developmentally-disabled adults). Colorado Springs offers such a robust set of resources, that it’s really about figuring out the needs for the specific adult. Working with TRE gave me insight into how families work with disabled adults, how local resources can be called upon. The caseload of people I worked with covered a range of adults who lived on their own, who I could meet at the local Village Inn or coffee shop, extending to folks living with their family or host home, including those who were nonverbal. Regardless of where someone was in capability, the biggest thing was advocacy, the existence of someone advocating for them. Host home providers in particular were huge advocates for the adults living in their homes. I learned how much strong advocacy relates to case management. This includes the client advocating for themselves — do they want a community-based day program, or one that teaches job skills. This city has an amazing set of skills specialists for that.
Was it the completion of the master’s degree that steered you more to the mental health community after your years at TRE?
I was working at TRE while I was going to school, and they were incredibly flexible with me for the two years I was there. They knew once I finished grad school, I’d be moving more toward be-havioral health. After graduation, I was able to find a job with what was then AspenPointe, now Diversus. I think it was my experience in Tulsa that allowed me to be comfortable with the population of AspenPointe and the level of addressing crises. I worked with adults who had serious diagnoses ranging from bipolar to schizophrenia to depression, all while navigating low income. A lot of my colleagues just coming in without community mental health experience found it was a huge shock. There’s no calm counselor’s desk, you are in go mode and crisis mode continuously. But I’d tell anyone in the field, if you want a great breeding ground for future work, a community mental health center is where to go.
There’s ongoing concern about how community mental health centers interact with law enforcement, and a continuous call for police to allow crisis teams to respond to certain public events.
In my experience with the local agencies, I think CSPD and the mental health agencies are working hard to find that ultimate formula. Many centers offer free mental health first aid, and CSPD has learned a lot from its Homeless Outreach Teams. The training that HOT teams got in the basics of mental health led to amazing results. There’s also BHCON (Behavioral Health Connect Unit), where an El Paso County Sheriff’s deputy is paired with a licensed clinician for a ‘co-response’ model. The kind of mobile crisis calls that result are a model nationwide in co-responding. Another wonderful resource is the CARES team, which can include people from the fire department, hospital, sheriff’s office, prison system — all of whom get together once a month to identify high-risk members of the community.
And what steered you to veterans and active-duty military support?
I was at AspenPointe six years, beginning as a clinician, then becoming a clinical supervisor for the child and family network once I was licensed, and did that for three years. Then I accepted a position as lead care coordinator with Colorado Community Health Alliance, which is the state Medicaid contract holder for behavioral health services. Physically, their offices are on the north part of town, but this was during pandemic, so a good part of the job was remote. I managed a team of 13 care coordinators, embedded in hospitals and schools, so we already were in a hybrid setting, but when the lockdown hit, everything took place from home. CCHA kept the safety of per-onnel paramount, so even though an occasional face to face meeting might have helped, it seemed like every time we planned a limited community presence, transmission rates went up again.
After four years with CHHA, I happened to spot the CVN position on Indeed. I loved my position with CCHA, and loved the project management and development piece, but I missed clinical work, it was where my heart was. From my own personal experience, I knew that after we were done moving base to base when my dad retired from the Air Force, the transition to a civilian community was very difficult for me and my mom. For me that included bullying, not knowing how to fit in, understanding what my role was. My family was incredibly supportive, but I knew how few services were available. So when I saw that CVN was addressing the needs of the family, it spoke to me. But before the Indeed ad, I knew nothing. For someone who has been in the Colorado Springs mental health community for so long, I thought I knew all the players. The more I researched online, the more intrigued I was.
It sounds like you knew immediately during the interview process this was a great opportunity.
Especially building a team from the ground up. I was the first employee, and the building had a stripped interior when I first saw it — no floors, no walls. I was working from home. The name ‘Clinic at Red Rock’ comes from the parent organization, Red Rock Behavioral Health Services, housed out of Oklahoma. Red Rock initially established a clinic in Lawton, Oklahoma and did such a good job, they were tapped to do one here.
Are you still dealing with issues stemming from the withdrawal from Afghanistan, or have we returned to a more typical mix of behavioral health issues, now there are no big deployments overseas?
CVN has always taken pride in being very relevant in how they train clinicians, and CVN also makes a point of saying we are who we serve. Most of the staff are veterans or reserves, and have their fingers on the pulse of what the up-to-the-minute need is. We try to identify emerging needs that would have an impact on family members, so we can offer training as needed. A year ago, Afghanistan was a key concern. Every clinic also has an outreach director who goes out to talk to stakeholders, military installations, to find out what issues are emerging.
Behavioral health in the military often focuses on high-profile PTSD cases, but you also deal with everyday family dynamics. Do you think the public understands the support needed for the military community?
I think we do a good job of communicating the breadth of services we offer. Sometimes things that seem mundane have a big effect on the vet and the family. Veterans may be retiring from jobs they held after their years in the service, so the ‘second retirement’ has an impact on the family. Any change of circumstance that can make an individual feel nervous or scared is an occasion to assure them they are not alone.
There’s a feeling out there — maybe unfair — that if you are on active duty, at least you are cushioned from the worst economic shocks. What do you think the real impact of inflation and job shortages are on your client base?
We have a case manager on staff, a veteran himself, who is very well-versed on economic needs of the community. And with his social work background, he knows both social determinants of individual clients, and what community agencies can offer for economic aid. Regardless of a certain career path for an active duty or veteran client, you can’t always predict what kind of impact that inflation and issues of job security is going to have on the spouse’s job. This is most definitely an element of what we have to address at the clinic. It’s important to remind people that conditions can change with the flip of a switch. My dad had an excellent career post-military, and was suddenly laid off, converting the family to a one-income home based on my mom working. When the economy is this uncertain, people in either military or civilian environments can’t allow pride to get in the way of accessing something like a food pantry.
It must be hard to balance the appropriateness of emotional support and talk therapies vs. prescribing a drug for very challenging problems.
This is why it’s important that we have fully licensed staff, and that we have good relations with health care providers. It also underscores the importance of case management in treating the whole person. Say a person tells you that increased depression is having a direct impact on health. We want to bring in the client’s health care providers — and if they don’t have a doctor, we want to help them get one.
What have you learned about building a brand new clinic where none existed before?
Since we just started moving some of the furniture in during October, it still feels new. Development of our team between April and October was fully remote. Our area for interns still is being worked on, but we can’t even take on in-terns until we’ve been in business for six months, so everything will come in its time. I have a huge newfound respect for any sort of contractor issues, such as building development, punch lists, HIPAA-compliant security, IT resources — they’re all the sort of invisible issues of creating a brick-and-mortar clinic that allows you to do the good work. We are the 23rd of 25 CVM clinics to be opening, so at least we can rely on experience. Our clinics are very similar in décor and layout — not to be cookie-cutter, but to allow clients who might have been to another clinic feel they’re in a familiar environment here.