Funder: Kaiser Permanente Community Health
December 2018 | Case Study
CJ Albani is the picture of health. As an amateur bodybuilder, he spends hours a day at the gym. He follows a diet, does not drink or smoke, and even avoids caffeine. As a certified personal trainer, he strongly believes in the connection between physical and mental health, having seen evidence of the role fitness has played in his own life.
Mental illness can go undiagnosed and relatively unnoticed for years. In Albani’s case, its onset was abrupt and devastating — he was diagnosed at 17 with schizophrenia and depression, and spent the summer between his junior and senior years of high school in a psychiatric institution. He credits his loving and supportive family, as well as adhering to a rigorous exercise regimen, with his recovery.
Today, he serves as a peer specialist with CirCare (formerly Onondaga Case Management) in Syracuse, New York. All peers have a diagnosed mental health disorder, though many have been in stable condition for years. Each peer specialist works with approximately 15 clients, and meets with them on a weekly basis for roughly three to six months. The program participants, who are referred by local health care providers, are all enrolled in CirCare’s Health Home Care Management program’s network. The network includes not only health care providers, but also the social and community supports essential to a person’s overall health, such as housing and vocational services. Peer specialists help clients access these services, as well as create a “wellness plan” — a list of emergency contacts, local resources, and hospitals they can use in case of a crisis. The program’s overall goal is to improve health outcomes while also controlling the cost of care, and reducing unnecessary utilization of emergency services.
“I don’t like to consider anybody institutionalized.”
Albani’s supervisor tries to connect peer specialists with clients based on similarities: whether in age, health issues, or life experiences. Recently, Albani was paired with a man in his 20s diagnosed with severe depression. Unemployed, the man struggled — as do many of Albani’s clients — with feelings of inferiority. “Because what is the most common thing that people ask you?,” says Albani. “They ask, ‘What do you do?’ [And] a lot of people do not know how to answer that…[They] don’t want to be on disability. They want to be working 40 hours a week, 9-5, supporting themselves.” After meeting a few times, Albani convinced the man to join him at the gym, and they have since become regular workout partners. Over time, the man’s ability to stick to a fitness regimen both improved his spirits and self-esteem, and he has begun working part-time at a bakery.
Albani continues to help his clients move beyond their diagnosis, and pursue their hopes and dreams for achieving success and happiness in life. He also lessens the stigma clients feel by comparing their conditions to other chronic illnesses, such as diabetes. “If you don’t treat it, it’s going to get worse…But the good news is you can get better. It’s just something you have to keep working on.”
Author: Mariel Gingrich, Center for Health Care Strategies.