Pat Rehmer has been on call since 1997.
“I have never been unavailable,” she said, adding, “It’s who I am. I have always had to be available. I have always had to know what was going on. I have always had to be able to support the staff.
Rehmer closes out a 40-year career in behavioral health on Dec. 31, which coincidentally is her 62nd birthday. She will be replaced by James F. O’Dea, Phd, MPH, Vice President, Behavioral Health Network.
“I’ve been doing this since I was 22,” she said. “It’s time.”
As President of the Hartford HealthCare Behavioral Health Network (BHN) since 2016, Rehmer has been responsible for the expansion of HHC’s behavioral and mental health offerings across the entire system, as well as adding coordination and consistency to services throughout the state.
As a new graduate of Skidmore College with a degree in nursing, Rehmer began her career in 1982 at Hartford Hospital’s Institute of Living, a critical component of the BHN, where she worked for 17 years. The Institute of Living (IOL) is one of America’s leading not-for-profit centers for comprehensive patient care, research and education in the fields of behavioral, psychiatric and addiction disorders.
At the IOL, Rehmer held a variety of positions, including head nurse, program director for the partial hospital program, director of adult programs and clinical director of operations. Rehmer’s clinical responsibilities included inpatient, outpatient, partial and residential services for children and adolescents, adults and geriatric patients. During that time, she earned her master’s degree in nursing from St. Joseph’s College.
“Pat Rehmer’s deep knowledge of the behavioral health system and her compassionate advocacy to find creative solutions and develop stronger networks served our patients and their families well,” Jeffrey Flaks, President and Chief Executive Officer of Hartford HealthCare, said. “We are proud that she launched her highly successful career right here at Hartford HealthCare.”
Not a lot of nurses choose psychiatric care as their specialty, Rehmer noted (she said it’s around 10 percent). It was a clinical rotation at Bellevue Hospital in New York while she was an undergrad that made her choose psychiatry.
“I was always interested in how the brain works,” she said. “With inpatient (psychiatric) care, you make connections. You get people as well as they can be. And as a nurse you had to be fairly independent, and that really appealed to me.”
When the policy changed and long-term residential patients began to be discharged en masse, Rehmer understood “people do get better. We saw them — even those with serious mental illness – get well enough to live in the community and do really well.”
She believes that a community approach to those with mental health challenges means a better chance for successful independent living. When she left the IOL and went to work for the state of Connecticut, she brought those ideas with her.
Rehmer joined the state Department of Mental Health and Addiction Services in 1999 as the Chief Executive Officer of the Capitol Region Mental Health Center, the Local Mental Health Agency serving the greater Hartford area.
She served as DMHAS Deputy Commissioner from 2004 through 2009. Gov. Dan Malloy appointed her Commissioner of DMHAS in November 2009.
During her tenure as Commissioner she worked in partnership with individuals in recovery, families, advocacy groups and service providers to ensure that individuals have a meaningful life in the community. Rehmer fostered strong collaborations with other state agencies, including working with the Department of Children and Families in establishing a Young Adult Services program for children transitioning from the children’s mental health system to the adult system.
She had oversight for the Mental Health Transformation grant, a $13.7 million grant from the federal Substance Abuse and Mental Health Services Administration, which included partnerships with 14 state agencies and advocacy communities, to transform mental health services in Connecticut.
She also led DMHAS’ implementation of the Medicaid Rehabilitation Option for individuals in group homes and the Home and Community Based Waiver to move individuals with behavioral health disorders who do not need nursing home care into the community.
Her previous work at the IOL coupled with everything she did at the state crystalized for Rehmer that a key component to recovery is pairing those who are seeking or just beginning their journey with those who have been through it successfully – those with “lived experience” working in a “recovery-oriented” system. The goal should always be, she said, to “get people better.”
“It’s all about giving people hope,” she said. “You have to meet them where they’re at, and if necessary, if they have no hope, you have to say to them, I will carry that hope for you. Those who lose hope are the ones most at risk.”
The Behavioral Health Network has brought this philosophy to the system in the form of Recovery Support Specialists, employees who are themselves in recovery who work in every HHC emergency department.
“When you walk into an ED with a substance abuse issue, you are not too popular” with the medical staff, Rehmer said. “Maybe you are a repeat visitor, maybe you don’t seem to want to get better, maybe they feel like you are taking up their time and resources. The recovery coaches are there to talk with you, gauge your desire to get help, find you a bed (in a recovery program), maybe even drive you there. And afterwards they maintain contact, and they are encouraging recovery. It has been an amazing lift to the system.”
HHC now has a Recovery Leadership Academy that trains these employees. “They don’t take the place of our nurses and clinicians,” she said. “But they are an integral part of the system.”
Rehmer was DMHAS commissioner during the Sandy Hook mass shooting that killed 20 first graders and six school staff in 2012. She and her team were boots-on-the-ground in Newtown for weeks after the event, working with mental health providers to care for the teachers, surviving children, families, and first responders. She said what happened at Sandy Hook set back mental health policy about a decade (as people shifted into a “lock them up” mentality as opposed to “get them help”) but she thinks another tragedy has helped reset the thinking.
“The COVID pandemic has had a huge impact on mental health,” she said. “In Connecticut, there are about 800,000 adolescents, and before the pandemic about one in four struggled with mental health. Right now, we are estimating it’s about 50 percent who are in mental health distress. It is a crisis for our children and access to behavioral health services is critical.”
In part it was the pandemic that led Rehmer to decide it was time to retire. “Three things happened,” she said. “I broke my leg, and had a lot of time recuperating to think about things. The pandemic had all of us working long hours. And my daughter had a baby. I have a grandson, and I want to be able to be available to them.”
“I’ve worked really hard my whole life, but I never felt like it was too much. I was never unhappy. My children have said to me ‘I want to love my work as much as you always did’ and that’s a great validation for me.”