Eastern Oklahoma VA Health Care System
VA Pioneers Recall First Mental Health Clinic
The Jack C. Montgomery VA Medical Center (JCMVAMC) recently said goodbye to two mental health pioneers, Steve Jones, Ph.D., and Janet Gearin, who retired respectively on Dec. 31, 2013 and Jan. 3, 2014. Both Jones and Gearin not only helped establish the first outpatient mental health clinic at the hospital, but also laid the groundwork for the hospital’s Behavioral Medicine Service.
JCMVAMC Director Fred Hoefer, who served Nov. 12, 1972 to Jan. 16, 1977, recognized the need for an expansion of the hospital’s mental health services and made the commitment to hire full-time mental health professionals.
Prior to that, the hospital offered mental health services to inpatients only and contracted the services of a local psychiatrist who treated them one day per month and also flew in two psychiatrists from the Oklahoma City VA Medical Center twice a month.
On March 10, 1975, the hospital hired Gearin, a Clinical Nurse Specialist, as the first full-time mental health professional. In June 1975, the hospital then hired Jones, a social worker, and later a psychologist and psychiatrist.
The new team was tasked with treating inpatients and starting a brand new outpatient clinic. Since the hospital did not have an inpatient mental health unit at that time, they also arranged for mental health patients to be admitted at nearby VA hospitals such as in Little Rock, Ark. and Topeka, Kan.
“I never knew what it was like to go home on time,” said Gearin. “We were helping anybody who had any kind of mental health issues. Any part of the hospital could call us.”
Jones said his youthful age was a benefit at that time.
“It was good I was young and had energy,” he said with a laugh. “We were pretty good at what we did. We provided the best care we could with the resources that we had.”
In the fall of 1975, the hospital officially opened the new outpatient clinic in Bldg. 9. Until then, Gearin and Jones worked wherever they could find a desk.
“I didn’t have an office,” said Gearin. “I was all over the place in the Emergency Care area. I was in what we now call Primary Care. I was also up in the hospital (treating inpatients).”
Gearin said one of the initial challenges was the lack of education about prescriptions that were available to treat mental health patients. With an academic background in psychopharmacology, the scientific study of the effects drugs have on mood, sensation, thinking and behavior, Gearin spent time educating physicians and gave advice as to which medications they should prescribe.
“It was all new,” said Gearin. “I knew all of the medicines and there weren’t that many back then as now. The doctors didn’t really know psychiatry or psychiatric medication that well. They relied on me to be able to tell them.”
Gearin said another challenge was giving a diagnosis to Veterans who suffered from Post-Traumatic Stress Disorder (PTSD), which wasn’t recognized as an official diagnosis by the American Psychiatric Association until 1980.
However, Gearin said she was able to recognize the symptoms of PTSD.
“I had a lot of guys coming in that had been in Vietnam,” said Gearin. “When a new patient would come in and said he was in Vietnam, I knew what he was going to tell me. I knew what kind of symptoms, complaints and problems he was going to have. But, at that time, we didn’t have a diagnostic category for it.”
Gearin said she is proud of her efforts to treat Veterans with PTSD.
“I knew then that I was going to be pretty good at this job,” she said. “I could help guys recover to some degree where they could go forward with their lives, and that gave me a lot of confidence to know that I was seeing and understanding what they were really trying to tell me.”
Gearin said she is proud of her work to help lay the foundation of the mental health program.
“Steve and I laid the foundation and I like to think we laid a very stable foundation,” said Gearin. “It was all pioneering back then. We really didn’t have anything to go by. We just developed a program and kind of flew by the seat of our pants. If Veterans needed hospitalization, we made sure they got in somewhere. If they needed outpatient therapy, we gave them outpatient therapy. If they needed medication, they were given medication.”
Today, the hospital employs more than 100 full-time employees who work for the Behavioral Medicine Service and provide mental health treatment at the Muskogee hospital, JCM East in Muskogee, Tulsa Behavioral Medicine Clinic and Hartshorne, Tulsa and Vinita VA Outpatient Clinics. In addition, JCMVAMC established a 15-bed Inpatient Mental Health Unit in 2006.
Jones said he is proud of VA for not only making a commitment to mental health, but also providing the resources to meet the needs of Veterans.
“The resources VA has given us has made a big, big difference,” said Jones. “When you go from having a psychiatrist half a day a week to where we have more than 20 psychiatrists now - that has to improve things. We now have more than 20 psychologists from one psychologist. We have around 50 social workers. We have quality staff and therefore we can provide quality care.”