The people and experiences behind my commitment to psychiatric rehabilitation and Advocate Support Services
James Crosson | Founder & CEO | Advocate Support Services, Inc.
I’ve been thinking lately about why I do what I do at Advocate Support Services, and where the seed for this work was planted. Over the years, I’ve worked in many different parts of behavioral health. But when I think about the experiences that have meant the most to me, I keep coming back to the people I’ve known and the opportunity I’ve had to be part of their lives.
One of my first experiences in behavioral health was a college internship at Crownsville State Hospital, where I led stress management classes with patients. After that, my first full-time job in the field was providing psychiatric rehabilitation services in a residential program.
Early in that work, I went with another counselor to visit someone at home. We knocked on the door, and the person who answered was someone I had known years earlier. I hadn’t seen him in a long time, and I hadn’t known what had happened to him. I was taken aback, but he was happy to see me, and I was happy to see him. I had known him in a completely different part of my life. Now, years later, I had an opportunity to support him.
I remember feeling fortunate that I got to know him again and help him. That experience has stayed with me throughout my career.
There are personal reasons this work matters to me, too. Mental illness has touched my own family, and I have experienced the loss of people I cared about to suicide. I’ve seen what mental illness can do to individuals and families. I’ve seen people suffer. I want to do what I can to help relieve that suffering.
The Work I Keep Coming Back To
Over the years, that commitment has taken me into substance use counseling, outpatient mental health, partial hospitalization, crisis services, day programs, and residential housing. I’ve worked in those services and owned businesses that provided them. They all have value. But I’ve always felt that psychiatric rehabilitation – the direct contact with people, face to face, in their everyday lives – offers one of the most meaningful relationships we can have with someone living with serious mental illness.
In my experience, that relationship can make an enormous difference in a person’s quality of life. It can support stability, create opportunities, reduce isolation, and help someone begin to see possibilities they might not have seen on their own. It is also deeply rewarding work.
At Advocate, we provide services in people’s homes and communities. We bring support to people where they live. For someone who finds it difficult to leave the house, or who has become isolated, that contact matters. It creates an opportunity to connect, try something different, solve a problem, build a skill, or simply have someone consistently show up and help.
Mental illness is often only part of what a person is managing. Some of the people we serve also live with serious physical health conditions and all of the practical demands that come with them. There can be a great deal to manage. Those people deserve the support they need to live the best lives they can, with opportunities for connection, purpose, stability, independence, and fulfillment.
Supporting the People Who Do the Helping
I also really enjoy the people who choose to work in this field. They are the helpers. So many of the people I’ve worked alongside genuinely want to do something good for someone else. They find meaning in their relationships with clients and in the camaraderie and support of their peers. I understand that, because those are some of the same things that have kept me here.
But finding the work rewarding should not be a substitute for being supported and compensated fairly. I want our employees to have good benefits, a good working environment, and people they can turn to for help. I want them to be recognized for the work they do and rewarded as well as we can afford. I have never felt that the compensation available to many of the people providing community behavioral health care fully reflects the difference they make in people’s lives.
That is one of the challenges I keep working on. We operate within reimbursement limits while also needing qualified supervision, administrative support, technology, and all the other things necessary to run a responsible organization. Behavioral health is complicated. There are regulations, accreditation standards, payer requirements, documentation requirements, and countless details that have to be right.
I believe those standards matter. They exist for important reasons, and we should meet them and in some instances, hold ourselves to an even higher standard. My responsibility is to help turn that complexity into clear, practical ways of working so the people closest to our clients can concentrate on providing good care.
Why Systems and Technology Matter to Me
That has become one of my central goals at Advocate: to make the delivery of the work as simple as possible for the person doing it. A caseworker should understand what is expected, have the tools to do the job well, and have support when something is difficult. They should not have to spend their day sorting through avoidable confusion or struggling with processes that we could make easier.
Documentation is a good example. It is necessary, and it should be done well. But I want it to be as straightforward as possible. When a worker is spending hours on paperwork that could be handled more efficiently, that is time and energy they cannot spend with a client. I want to protect the opportunity for an in-person visit, a meaningful telehealth conversation, or the direct support that brought that worker into the field in the first place.
That is why I spend so much time on technology, data, processes, and systems. I’m trying to make the actual delivery of care the priority. I want the organization to work efficiently enough that we can give more attention to clients and do better for employees, including paying them as well as possible. To me, the systems work is connected directly to the care, even when it happens far away from a client visit.
That commitment also extends beyond Advocate. As a citizen and a business owner, I try to support and champion behavioral health services, especially psychiatric rehabilitation. I want better reimbursement, a better health insurance system, and a more efficient health care system. I want more of our resources to reach the people who need care and the people providing it.
A Privilege, Not a Burden
When I describe all of this, I understand why it can sound like a burden. There is a lot to keep track of, a lot to learn, and a constant need to decide what deserves attention next. Sometimes it is stressful. Sometimes things feel shaky or uncertain. But that is not how I primarily experience my work.
I feel blessed that I get to do it.
It is a little like looking at my yard and knowing that I need to cut the grass, trim the bushes, edge, weed-whack, and pick up the sticks. There is work to be done, and it takes effort. But I’m also grateful to have that yard and to be able to take care of it. The effort does not take away the pleasure of having something worth caring for.
That is how I feel about Advocate. I have an opportunity every day to use my mind, create something, learn something, and help people. I get to look at what could be better and try to improve it. I don’t take that opportunity for granted.
I know I don’t control every outcome. I do have choices about how I respond, what I pay attention to, what I think, and what I do next. I can influence the environment around me, even when I cannot determine exactly how everything will work out. I try to keep my attention on that opportunity rather than let uncertainty become the whole story.
The direction remains clear to me: help people live better lives, support the people doing the helping, and make the work a little better every day. I don’t expect to finish all of it. I look forward to having another day to move it a little further.
I have a limited number of days in this life, as I understand it, and a limited number of days when I will be able to do this work. I hope both last as long as possible.
Being able to spend those days learning, creating, and helping people is a pleasure and a privilege. It is why I look forward to going to work.
| ABOUT THE AUTHOR James Crosson is the Founder and CEO of Advocate Support Services, Inc., a Maryland community-based psychiatric rehabilitation provider. His career in behavioral health has included psychiatric rehabilitation, substance use services, outpatient mental health, crisis services, partial hospitalization, day programming, and residential services. His work at Advocate focuses on building systems that support clients, strengthen the people providing care, and make high-quality community behavioral health services easier to deliver. |