In 1989, what we now know as WellPower was created as a nonprofit organization to centralize and consolidate four mental health centers in the City and County of Denver. In the 36 years since its inception, WellPower has evolved, expanded and adapted to meet the needs of our community. From the very beginning, Dr. Clark has been here, and as the organization and community prepares for his retirement at the end of 2024, we’ve asked him to reflect on his remarkable career and speak about his hopes for the future of behavioral healthcare.

Dr. Clark, what inspired you to get into this field?

I arrived in this field in a unique way – while deciding on a specialization in medical school I knew I was fascinated by human behavior and the mind, and while doing grand rounds I understood what truly had been driving me. By simply pursuing the things that interested me, I realized that I had actually been drawn toward psychiatry in a profoundly personal and meaningful way because of my dad.

My dad had bipolar disorder and suffered through some very hard times, including experiencing suicidal ideation. My family was so fortunate that care was available to him in a mental health facility where the staff were knowledgeable and compassionate. They saw that he was a great person who was being derailed by mental health challenges, and thankfully they helped him get well. Once I realized that this was driving me, I knew I deeply wanted to work in the community, because it was community mental health that had helped my dad.

How has the behavioral health field changed throughout your career?

Prior to the 1960s, people were often locked away, or institutionalized, if they had a mental health condition. When you look at photos of institutions and prisons from that era, there is not much of a difference. Following the deinstitutionalization movement, it took quite a while for places like Denver to get organized around how to help vulnerable people with consolidated community-based care. In the 1980s and early 1990s, this meant setting up places like what was then known as the Mental Health Corporation of Denver. At that time, what was provided was simply illness management; someone would come in, and we would focus on taking care of their illness, and less on what they needed to live the life that they wanted. Throughout the 1990s our focus really shifted to a recovery mindset, meaning we wanted to help someone recover the things around them that supported a full life – things like family, work, community and education. Recovery is so much broader than illness management, because people are so much more than their diagnoses.

Another shift came in 1999 when Martin Seligman at the American Psychological Association said, “We study all the things that go wrong, why not study what goes right with the brain?” With that the field of positive psychology came into being, and it fit so seamlessly with the work we were doing to build folks up. Everyone we see at our organization has strengths that you can tap into to help them on their journey of where they want to be.

What are some points of pride as you look back on your career?

There’s a quote that says, “The world is run by people who show up” and so I’ve always made it a priority to show up. I was elected to the board of the National Council for Mental Health, and we knew we needed to focus on policy to support the work of community behavioral health. We took the time to learn the system and achieved a couple significant things: one, there was no federal definition of a community mental health center, so when funding would be approved, we weren’t even on the list to get any of it. So, we created this federal definition and that’s how the Certified Community Behavioral Health Center (CCBHC) came to be. That led to ten pilots in ten states that showed improved access and quality of care. Over time we’ve now established a model that every state in the country can implement, and that’s where we are now.

There are also two bills at the federal level right now to move this model into the Centers for Medicare and Medicaid Services (CMS) so that there’s a permanent model to fund this. I feel very proud that, even though it took nearly 14 years, it’s on the verge of being everywhere in the country and if it goes into CMS it will be the first time mental health is funded by an actual mechanism rather than by grants.

What are some ways you’ve used your expertise to make big changes happen?

I think we were doing “human-centered design” long before we knew there was a name for it. We’ve always asked people we serve and families “what can we do better?” There were things in the very beginning where the feedback was “Medicines are too expensive, and we need help with that.” So, we started a pharmacy and used the profits from the pharmacy to fund medications for people who couldn’t afford them. We worked on legislation to get a pot of money dedicated to this as well.

Another was “it’s really hard to get well if you don’t have a place to live.” So, we created the Sabin Group, which is a wholly owned subsidiary where we develop affordable housing. Then, when looking at how to do better by children, we found a place in the city where people needed access to help that just wasn’t there. One of those areas was in North Park Hill, and they told us that, among other things, they needed better food. So, we put in the farm and the aquaponics greenhouse along with a dental clinic and childcare services.

Working with the community has always really shaped how our programs have come into being. And we’ve had to deal with a lot of opposition and “us and them” thinking, especially related to folks with mental illness and the unhoused population.

One thing that has been useful in getting things done is something that we’ve also really internalized within the organization over time: we deeply believe that everyone wants to be great. When you take that recovery mindset and apply it to how you advocate for change, it impacts how you interact with people you might disagree with.

I specifically remember a time when there was not enough money from the state to continue all the services we had. We needed to do the thing that would have the least impact on people we serve and staff, so we decided to close two group homes. We let the state know, not from a place of blame but from a place of just not having the money, and they genuinely came to the table and figured out how to find the money so that we could keep those two group homes. Approach and attitude have made a big difference.

What is the biggest threat the behavioral health community is facing right now, and how do we tackle it?

People often say that the behavioral healthcare system is broken, and that is a misdiagnosis. You can’t break something that was never built. The system is malnourished; there is no place in the world that has put enough resources into mental health, and until we realize that there will always be gaps.

I do hope that Colorado becomes a Certified Community Behavioral Healthcare state because it will go a long way toward exposing how underfunded we are and will show what the actual costs are for providing services to our community. In this field, we see examples every day of how mental health improves when people are able to get the wrap-around support they need. If we put the necessary resources into this recovery-based model for health and well-being, the system would see costs go down for virtually everything else. It’s just taking time for that view to catch on.

Something that gives me hope for the future of this work, though, is that, as awful as the COVID-19 pandemic was, we saw a change in how people thought about mental health. What shifted was this idea of “well people” versus “unwell,” or “sane” versus “crazy.” The pandemic impacted everybody’s well-being, and there’s been this groundswell of people acknowledging that they both need and want help when they are struggling. If we can sustain that mindset, it will go a long way.

And finally, what are you most looking forward to as you begin retirement?

There are a lot of things I love doing that I simply haven’t had as much time for as a CEO and practicing psychiatrist. I’m certainly going to enjoy doing more snowboarding, more traveling, reconnecting with people from other areas of my life and my husband and I are even planning on hiking the Colorado Trail.

I still love this work, so there is no finish line for me when it comes to community behavioral health. I’m proud to have been part of a movement to ensure people who need access to care have access to care. The best thing for me is to see someone get care and then continue their well-being journey with the confidence they need to live the life they truly want. That’s been deeply rewarding and something for which I’m grateful.