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HRS at Fifty
50th Anniversary Brochure
More than 50 years ago, a man of unusual
conviction and insight created a model of community
mental health that promoted wellness through
prevention and awareness. Today, at the small,
vibrant organization he founded in Wellesley,
Massachusetts, these convictions and insights
live on.
Erich Lindemann, M.D., was a true visionary,
a man who saw and applied inventive — yet
perfectly logical — solutions where others
saw only problems. In fact, so keen was his vision
in matters of mental health that, in 1948, he
discerned a solution to a predicament others
didn’t even know existed.
The problem he identified was the emotional
disruption that ordinary, well-adjusted people
experience in reaction to certain events that
occur in everyday life. The remedy he conceived,
a program of community-based mental health intervention,
became the philosophical cornerstone of The Human
Relations Service, Inc.
As chief of psychiatry at the Massachusetts
General Hospital, Dr. Lindemann was renowned
at the time for his research in human grieving
and reaction to crisis. Based largely on those
studies, he was asked by a group of Wellesley
citizens to create a “mental hygiene” program
that would address the few acknowledged behavioral
concerns among the town’s youth.
Ever ahead of his time, Dr. Lindemann seized
the opportunity to study a long-held tenet: that
mental health prevention techniques could help
individuals, especially children, to cope with
certain life crises — events as profound
as a family death or as commonplace as moving
to a new home. Dr. Lindemann’s seminal
work with children in the grant-funded project
known as “The Wellesley Human Relations
Service” showed that intervention before
predictable occurrences, such as starting school,
can safeguard against serious emotional problems
later on. Today, with public schools in most
states requiring an evaluation of every matriculating
child, mental health intervention is as much
a “given” as polio vaccine, even
if it is less widely administered.
Equally important was Dr. Lindemann’s
deep belief in the importance of community involvement
in establishing and maintaining wellness. Long
before any minivan bumper sticker or book jacket
bore the aphorism, “It takes a community
to raise a child,” Dr. Lindemann was recruiting
members of Wellesley’s clergy, police force,
town government and other institutions to help
articulate HRS’s mission with credibility,
authority and compassion.
These ideals still reside, relatively unchanged,
at the heart of HRS. Despite a vastly different
health care environment and mental health sensibility
than existed in 1948, the agency’s sights
are still fixed on maintaining health through
intervention and fostering an inclusive program
fashioned by and for the entire community.
While Dr. Lindemann’s specific methods of evaluating the behavioral propensities of
children are no longer used at HRS, the same
concepts are applied through consultation programs
implemented in eight school systems in Wellesley
and nearby towns. HRS counselors meet regularly
with school administrators, guidance personnel
and teachers to discuss issues related to counseling
students. Occasionally, sessions are also held
with segments of the student body.
Through the consultation work of Dr. Robert
Evans, HRS’s executive director since 1980,
the agency has gained an even higher profile
in the scholastic community. Author of The Human
Side of School Change, he frequently meets with
faculty, administrators, and parent-teacher organizations
across the state and around the country to explain
the societal and emotional forces that shape
students’ personalities and the roles seminar
participants play as educators and authority
figures. As with the agency’s contracted
services, these activities extend HRS’s
legacy of classical prevention by empowering
school staff to recognize warning signs and intervene
before full-blown problems emerge.
HRS remains similarly devoted to the community
orientation that traces back to its roots. Today,
just as the agency is a critical part of the
communities it serves, so are those communities
an indispensable part of HRS. A kinship with
people representing every aspect and element
of local life ensures that HRS understands and
accommodates the needs of the populations it
serves. Through vital bonds with leaders in religion,
politics, law enforcement, business, education
and charity, HRS functions at the core of an
organic network — a community, in the truest
sense — of individuals and organizations
that play distinct roles in protecting wellness.
As was true since 1948, HRS is represented
by a board whose diversity in vocation, ideology,
interest and character ensures that the agency
is both represented and guided by its constituencies.
Drawn from Wellesley, Weston and Wayland,
these trustees bring considerable energy, passion
and professional savvy to their work. And they
bring something else: a lasting commitment. HRS
trustees typically stay on for nearly 10 years,
far longer than the average tenure for other
such organizations. Continuity and longevity — for
both the board and the agency itself — are
clearly grand traditions at HRS.
Managing change is a formidable challenge for
any health care organization that aims to preserve
the purity of its vision. For some, it’s
enough to survive, and sadly, countless community
mental health agencies have been unable to do
that in recent decades. (There is irony in the
fact that therapy, now embraced openly in most
factions of American society, is in tall demand
but very short supply because of the stranglehold
of managed care.)
Yet, amidst a turbulent sea of change, HRS has
persevered — even prospered, some might
say. It has succeeded, simply, because of the
resourcefulness, agility, and commitment of its
staff, board, benefactors, and allies in the
schools and governments of the towns it serves.
To be sure, HRS has encountered its share
of obstacles through the years, the earliest having
to do with acceptance, the majority dealing with
funding. At the outset, HRS had some grant money
(albeit, in modest amounts) but relatively no
approval in Wellesley. Psychiatric institutionalization — segregation
from “normal” society — was
the standard treatment of mental illness at that
time, and the idea of dealing with emotional
problems right here in the neighborhood made
people very nervous. For years, HRS had trouble
finding a home where it was received with anything
but animosity and skepticism.
Through ceaseless efforts by the HRS board and
staff to demystify basic psychological concepts,
mental health care gradually gained acceptance
in Wellesley. But while HRS was finally winning
validation among town residents, it was suffering
financially. Struggling to make ends meet, impending
poverty became the agency’s biggest worry.
Astute management and decision-making in the
1970s started HRS down the long road to fiscal
stability, although it wouldn’t fully reach
that destination for another two decades (and,
in some respects, still has not arrived). First,
its archaic budgeting and record-keeping methods
were overhauled in the mid ’70s, affording
HRS the sophistication it needed to seek and
secure town funding. Then the agency became eligible
to receive third-party payment — it was
the state’s first mental health organization
to so qualify — uncovering a brand new
means of funding its services.
But more trouble lay ahead. A full one-third
of HRS’s operating budget, which had been
provided for years by the Massachusetts Department
of Mental Health, would be revoked around 1990,
again imperiling the agency.
It’s said that in Eastern cultures, “crisis” and “opportunity” are
often indistinguishable concepts; in fact, certain
Chinese dialects employ the same character for
both words. When faced with the loss of the state
subsidy, HRS’s caretakers must have looked
Eastward, because they found opportunity in the
midst of potential crisis.
The cutbacks motivated HRS to create new services
and sources of revenue, allowing it to weather
a storm that has consumed other community mental
health organizations. By offering consultation
services to schools outside Wellesley and Weston,
the agency has expanded its geographic reach
and now extends its services to more educators
and students. By creating Employee Assistance
Programs, HRS helps individuals cope with the
stress of work, family, and other daily responsibilities.
By forging relationships with local pediatricians,
HRS has opened up new channels of referral while
supporting more children in need of early intervention.
And by subtly shifting the clinical emphasis
toward treatment, the agency is now better able
to accommodate its no-fee and sliding-scale casework
and fund the more costly child and family intervention
services that preserve its original mission of
preventive community care.
Looking ahead, one must anticipate continuing
change in the way health care is delivered, consumed
and funded. Certainly, events of the last 15
or 20 years have altered health care concerns
of every color and stripe and, for better or
worse, there is every reason to believe the mental
health field will continue to evolve.
Conceived half a century ago as a facility for
research and training in the theories and practice
of community mental health, HRS is a different
organization today. Because it no longer receives
national grant money, and because research and
teaching does not pay the bills, the emphasis
has shifted to treatment and consultation. The
future promises further challenge.
“It’s very difficult to project
what’s ahead, for HRS and mental health
in general,” says Dr. Evans. “One
thing we know is that it’s getting tougher
to care for the populations we serve. In our
society, kids are being pushed to do more with
less support. As a result, we’ll continue
to see a greater number of serious problems and
fewer transitional ones. And our job will be
made even harder by the continued erosion of
the community, which once played such a prominent
role in upholding people in their times of need.”
In the years to come, HRS must keep pace with
the community’s requirements while sustaining
itself financially — objectives too often
at odds with one another. Dr. Evans believes
the agency will achieve both aims by creating
new programs that are consistent with the agency’s
areas of competence and original mission and
by encouraging a controlled expansion of its
geographical service area. These new services
and populations will enable HRS to both retain
a rich cadre of staff and subsidize several “wish
list” programs that otherwise would be
too expensive to offer.
It is these programs — outreach to lower
income neighborhoods; fee-scale adjustments for
town residents near the poverty line; no-charge
services for families suffering a chronic illness;
expanded behavioral programs; an extensive community
outreach effort by more staff members; and expansion
of the agency’s special education summer
program into the school year — that tie
the HRS of 1998 to the work and ideals of its
founder.
Indeed, Dr. Lindemann would be pleased. He would
appreciate the cold realities of the day and
respect the resilience and adaptive measures
of his successors. And he would be proud that
in these difficult times, the agency he built
not only survives where others have succumbed,
but also carries high the torch of innovation,
prevention, and community-wide commitment that
he and his colleagues instilled in The Human
Relations Service decades ago.
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