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MOUNT VERNON — A pioneer in mental health and substance abuse care called on Skagit County’s care providers Thursday to adopt a more empathetic model.

In a lecture to practitioners, Dr. Mark Ragins pushed against the traditional model of medicine — in which a patient is viewed primarily through the lens of a diagnosis — and encouraged those attending to view their clients as people, and allow them to help direct their own care.

“The medical model is firmly entrenched in the intellectual level,” he said. “People want to be engaged with as a person, not a diagnosis.”

Ragins spoke to a group of about 50 who work in the field of mental health and substance abuse — referred to collectively as behavioral health.

He worked for 27 years as medical director at Village, a Mental Health America of Los Angeles care center, and as a psychiatrist for students at California State University Long Beach.

He was invited to speak in Skagit County by the Mount Vernon Police Department. He gave similar talks later in the week to local police officers, and policymakers and leaders in behavioral health.

Police Chief Chris Cammock said Ragins’ ideas are important to consider as the county begins reevaluation of its approach to homelessness and behavioral health through Project North Star.

Cammock is working to expand his department’s embedded social worker program, and will implement the model of care that Ragins advocates.

Ragins said his approach developed during his time working with hospice patients, where care is centered around the patient, and driven by the desire to make their remaining time as comfortable and enjoyable as possible.

He said he would sit with terminally ill patients, watching TV or helping to record an oral history, so they wouldn’t feel so alone in their final days.

Why, Ragins thought, did patients have to wait until the medical model had failed them before they could have a hand in directing their care?

“We can be inspired by their example, as the best person-centered care in medicine,” he said.

The behavioral health model for which Ragins advocates focuses on empathy, collaboration and building trust. This means putting aside the traditional doctor-patient relationship, where the provider is an authority figure, he said.

Instead of focusing on diagnosis and treatment, his model has providers working with patients to make a care plan that emphasizes the goals of the patients, helps them to find community and rebuilds crucial life skills.

Connection and a feeling of belonging are extremely powerful, and have shown to be motivators for those working to address their issues and get their lives in order, Ragins said.

Even if providers understand the flaws in the medical model, that model’s influence is powerful throughout the behavioral health system, Ragins said.

Because funding is tied to diagnoses and treatment, management and insurance companies have great influence on how care is administered, what medical research is performed and what success stories are told, he said.

Maybe the best way to help a patient is by helping them find something they’re passionate about, or getting them connected to a community.

“If you want to get paid, how are you going to bill for that?” he said, reflecting on challenges to changing the model.

In the face of problems in entrenched systems in health care, it’s easy to get discouraged and burnt out, he said. But it’s important to remember providers can still have a huge impact on the individuals with whom they work.

“We can still be profoundly effective, even if we can’t solve the world’s problems,” Ragins said.

— Reporter Brandon Stone: bstone@skagitpublishing.com, 360-416-2112, Twitter: @Brandon_SVH

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