Lisa Lipscomb had survived tough times before, having worked on a short-staffed hospital unit during the worst days of the COVID pandemic. Transporting patients and working in housekeeping, “I saw horrible … horrible … ” she said, leaving the thought unfinished.
But a family crisis “tore up my soul. It got so bad that I tried to take my life. Then I went in the hospital for two weeks.”
The Roanoke resident was diagnosed with post traumatic stress disorder (PTSD). Upon discharge from a psychiatric unit in April, she needed follow-up care, but her options were limited. She has Medicaid but not all private practices accept it, and those that do often have long waiting lists.
Lipscomb was referred to the Bradley Free Clinic in Roanoke’s Old Southwest.
At Bradley, she sees a psychiatrist and a counselor.
“I’ve come so far from where I was when I first came here,” she said. “They’ve helped me tremendously. And, I feel good. Every day I get up and look forward to it.”
Lipscomb is one of many patients who receive services in the William and Margaret Robertson Behavioral Health Wing, which opened in July. The new wing is helping Bradley meet increasing demand for mental health services.
At the beginning of 2019, the clinic had fewer than 50 mental health patients. That year, Mental Health America of Roanoke Valley, which served uninsured psychiatric patients, closed its doors. Those patients transferred to Bradley. “I knew that we were going to need to expand because we had already filled every nook and cranny in this building with staff and patients,” said Janine Underwood, Bradley’s executive director. “We were kind of doing makeshift counseling in exam rooms and office space.”
Around the time the new patients were transitioning to Bradley, Underwood got a call from the Robertson family — fortuitous timing she refers to as “the magic of the Free Clinic.”
William “Willie” Robertson of Salem, a longtime supporter of Bradley, died in 2019. His children made a donation of $100,000 that launched an effort to raise money for a new behavioral health wing. It was named for William Robertson and his wife, Margaret, who died in 2021.
Richard Rife designed the 1,900-square-foot wing, which includes a new reception area, six counseling rooms, a group therapy room, office space, and a flex space for speech, physical and occupational therapy. (Disclosure: Rife is related to Cardinal executive director Luanne Rife.) The addition extends the building at 1240 3rd St. SW into the parking lot. The cost was $1.3 million, funded by the city of Roanoke ($310,000), the Virginia Health Care Foundation ($125,000), the Roanoke Women’s Foundation ($100,000), the Community Foundation ($67,000), Bradley board members and other donors.
Louis Tudor was a well-known swimming coach and restaurateur in Roanoke who served biscuits to downtown workers at his family’s store on Church Avenue. Struggling with mental health amidst the pandemic shutdown, he died by suicide on July 1, 2020. Family members established the Tudor House nonprofit dedicated to suicide prevention, education and support. Tudor House made a $25,000 donation to the new wing.
“Unfortunately, Louis was trying to seek services in the midst of a pandemic,” said Kathleen Thorell, executive director of Tudor House. “And so there was a lot of roadblocks. There are always roadblocks, but he had even more to deal with, just based on that everything was shut down. And so our goal is always to try to reduce those roadblocks. Obviously, some of the restrictions from COVID have lifted. So those things are not as bad, but it’s still very difficult to get in with service providers. And if you’re already struggling, that makes it even harder to stick with it.”
Another well-known Roanoke Valley family who made a donation were the Chiglinskys.
Joanne Chiglinsky was a licensed clinical social worker who volunteered at the Free Clinic in addition to serving clients in a counseling practice with her husband, Michael Chiglinsky. Their children, Brian, Peter and Katherine Chiglinsky, grew up in Salem. Brian became the director of speechwriting for the Department of Health and Human Services during the Obama administration. He lives in Falls Church and is director of communications for a health care company.
2021 was a very bad year for the Chiglinskys. Michael Chiglinsky died from complications of surgery for cancer in April. Joanne Chiglinsky died September 2. Their children established a scholarship named for their father, and donated $25,000 to the Bradley in memory of their mother. “It makes us feel closer to them and it makes us feel like there can be some good coming out of losing these two really caring people,” Brian Chiglinsky said.
Joanne had an eating disorder when she was younger, and battled depression and anxiety throughout her life, Brian said. “Her life was really a reminder that the struggles that you face can actually help connect you with others who are struggling, and empower you to help them.”
As a volunteer at the Bradley, Joanne Chiglinsky found it meaningful “to have this ability to reach out to patients who might otherwise be excluded from the system and wouldn’t have access to the mental health treatment that they need.”
The family’s gift helps not only the patients, but also the volunteer clinicians, Brian said.
One of those clinicians is Dr. Brooke Burns, a psychiatrist who works at Catawba Hospital. Burns said the range of diagnoses in the Bradley clientele “pretty much matches” the general population. But among Bradley patients, she said, mental health issues are aggravated by poverty “and all of the stresses that go with it, worrying about your lights getting turned off, worrying about whether or not your food stamps are going to last to the end of the month.”
The pandemic has made matters worse. According to an American Psychological Association survey released in October 2021, more than 84% of psychologists who treat anxiety disorders and 72% of psychologists who treat depressive disorders said they have seen an increase in demand for treatment since the start of the pandemic. In the Roanoke Valley, a community health assessment in 2021 identified access to mental health services and substance abuse services as the highest health priority facing the community.
Bradley expects to serve more than 1,000 patients this year with counseling, psychiatry and peer recovery services, in addition to the medical, dental and pharmacy care it has provided since its inception in 1974. The clinic’s operating budget is over $2 million not counting the value of services provided by nearly 300 volunteers. The largest revenue source is grants from foundations and trusts, followed by individual donations. The clinic started billing Medicaid in 2020, first for medical services, then for dental. It has not yet started billing for behavioral health visits.
To be a patient at Bradley, an individual must have an income at or below 300% of the federal poverty level and be uninsured or on Medicaid. Nearly 45% of patients are on Medicaid. More than 1,500 new patients registered during the fiscal year ending June 30th, 2022, a 40% increase over the previous year.
Bradley’s clientele is similar to that of Blue Ridge Behavioral Healthcare. “There is some overlap, but mostly the services are different,” Underwood said. “They offer more acute and crisis-related behavioral health services. We focus on psychiatry, counseling and peer recovery services and integrate behavioral health in a primary care setting.”
Even though many formerly uninsured people are covered by the Affordable Care Act, “there are always going to be people that fall through the cracks,” Underwood said.
From one psychiatrist and couple of counselors, the volunteer staff has grown to 10 psychiatrists and a dozen counselors, said Christine Wright, behavioral health program manager. A mental health diagnosis is now the most common issue bringing people to the clinic. Most mental health patients come in once a week for a one-hour appointment. “As they progress, it may decrease down into bi-weekly or monthly sessions,” Wright said.
With therapists in the private sector typically charging $150 per session or more, the monetary value of counseling provided at Bradley is “pretty astronomical,” Wright said.
Among mental health patients, many have a co-occurring substance abuse diagnosis. Bradley does not provide substance abuse treatment, but peer recovery specialists, part of the clinic’s Hope Initiative, provide “case management, peer support, linkages to resources, anything from detox, inpatient, outpatient, medication-assisted treatment, recovery, housing, and mental health services, support groups, wherever they are in their journey, and then work with them for a minimum of a year as they build that foundation for the recovery,” Wright said.
The stress of the pandemic escalated the need for substance abuse support as well as mental health treatment, Underwood said. “And so the Hope Initiative was needed even more. So everything just aligned, the community came together with the funding, and the Free Clinic was here to fill the need. I’m always humbled at how everything seems to fall in place. When there’s a need in the community, the Bradley Free Clinic’s here.”