Florida Partners in Crisis

Neal Dwyer: Building Partnerships to Improve Services

Neal Dwyer may have retired as the Department of Children & Families’ Circuit 10 mental health and substance abuse chief, but he didn’t retire his passion for helping people and working for change.

Dwyer’s retirement this past July 31 ended a more than 30-year career with the state’s social services agency, more than 15 of those years in the Circuit 10 post where he managed publicly-funded behavioral health services in Polk, Highlands & Hardee counties. 

Over his years with DCF, Dwyer worked to build strong community relationships and to bring all stakeholders together to work collaboratively to improve treatment and support services.  While building those partnerships, he also earned a reputation among his former DCF colleagues and in the community as someone who cares deeply about helping people.

His accomplishments were all the more remarkable because he operated in a circuit that one former colleague described as “one of the most poorly staffed circuits in the state, but one that gets the job done.”

“I spent a lot of years in the system, trying to do a good job and to help people,” Dwyer explains simply when asked about his effectiveness in bringing about change over the years.

A part-time job led to a career choice
Dwyer’s interest in mental health dates back to his service in the U.S. Air Force.  A medic stationed at MacDill Air Force Base in Tampa, he got a part-time job as a psychiatric technician at a children’s psychiatric hospital in the area.  “It was my first experience working with people with mental illnesses,” he said.  “I saw a lot of children getting better and saw a lot of good things happening. 

After his discharge from the Air Force, he went to work at the hospital fulltime and also went back to school to get a degree in psychology.

When he learned in 1975 about a new treatment and research program focusing on seniors with mental illnesses operated by the Florida Mental Health Institute (FMHI) at the University of South Florida (USF) in Tampa, Dwyer applied.

He trained at FMHI, then worked as a treatment and rehabilitation specialist in the program, eventually becoming unit director for the 32-bed geriatric residential treatment facility.  While at FMHI, he earned his master’s degree in gerontology at the USF.

In 1989, he went to work as the adult mental health program specialist in the then-Department of Health & Rehabilitative Services District 6 office in Tampa.  He later moved over to the District 14 (now Circuit 10) office when it was created in February 1994, and became the Substance Abuse and Mental Health Program Supervisor. 

“Going to work for HRS was a big change for me; having to learn how to deal with the bureaucracy takes a lot of time,” Dwyer said. “One thing I learned was that you have to be persistent. You have to pick your battles and quietly keep pushing for getting the needs met.”

Staying ahead of the curve
Dwyer was also ahead of the curve in some developments in his region. 

“One of the things I am most proud of was engaging community stakeholders in working together to plan services, “he said.  “They weren’t used to being asked for their opinion. In the past, it was difficult for them to get their voices heard. “

He encouraged providers in Circuit 10 to join the Central Florida Behavioral Health Network ― now a collaboration of nearly 30 providers serving people in nine counties in the Tampa Bay area and across central Florida. 

The Network provided a means for providers to more effectively work together. Then, creation of a regional council for the area offered still another vehicle for bringing providers, community leaders, consumers and other stakeholders to the table to identify service needs and plan ways to improve service delivery.

“He was extremely supportive, “said the Network’s CEO, Linda McKinnon. “He understood the power of networking and worked with us to develop the means to get things done.”

He also pushed providers to move toward implementing co-occurring treatment services to better serve people diagnosed with both a mental illness and a substance use disorder.  Part of a statewide move by DCF, the concept has been slow to gain traction in many areas.

Emphasis on co-occurring treatment services
To help spur cross-training and other steps necessary for agencies to effectively respond to people with co-occurring disorders, Dwyer funded a full-time position to focus solely on improving area providers' ability to provide integrated treatment services.

Doris Nardelli, the Co-Occurring Systems Coordinator for Circuit 10, works with all provider agencies and community stakeholders to improve the capability of providers to offer integrated treatment at one location.

Nardelli said all of the state-supported providers in Circuit 10 are now co-occurring capable.  “Now we’re working on bringing other providers into the co-occurring system of care,” she said. . 

And, according to McKinnon, Circuit 10 was the only DCF area in the state to incorporate both mental health and substance services in its transformation plan — part of a statewide initiative   to transform the publicly-funded mental health system to one that is more consumer and family-driven and embraces prevention, recovery and resiliency.

To better assure input from consumers and family members, Dwyer hired a family transformation specialist and an adult transformation specialist.  The positions are held by a family member and a mental health services consumer.

When a Partners in Crisis chapter was created in the region, it provided another means of  networking for advocates, providers and local officials.  Because of its strong participation, Partners eventually “took the lead in community collaboration and planning,” Dwyer said.

Dwyer was asked to serve as a facilitator for the new Partners chapter when it began nine years ago.  Today, he serves as Partners’ chairperson in Circuit 10 ― and Dwyer says he plans to continue playing a leadership role in the organization.

Bringing people to the table
“Partners brings people to the table who aren’t typically involved in substance abuse and mental health issues,” he said. “I think it’s done a lot to solidify credibility (of advocates).”

As an example, he said that when consumers, family members, law enforcement officials, judges and others coalesce around an issue and stand up together before a legislative delegation, “it has quite an impact.”

On a system-wide basis, Dwyer believes that one of the most significant changes he’s witnessed is the focus on identifying individual consumers’ needs and fitting their treatment to meet those needs.

 “We are much more sensitive and concerned about people in need of services and are trying to build the system around them,” he said. “That’s a huge transformation.”