Diagnosis: disarray

Diagnosis: disarray

Susan Brill worked as a psychiatric clinical nurse specialist at Northeastern’s Lane Health Center from 1995 until this past summer. By all accounts, she was a happy employee. She enjoyed her work, was allowed to head up a committee that drafted ideas for improvements and liked the management she worked under.

But with the merger of the Lane Health Center and University Counseling Center to form University Health and Counseling Services (UHCS), that all changed.

Over the past six months, Brill and 14 of her former colleagues have left UHCS, citing rifts between staff and new management that has led to a loss of morale. The change process, which has been ongoing for a year and a half, left many staff members feeling marginalized by administration, including UHCS’s Executive Director Roberta Berrien, Brill said.

“It was difficult to watch the place being taken apart,” Brill said. “People who worked there for many years were made to feel like they didn’t matter.”

Though an outside contractor was brought in to oversee the merge and manage complaints from the two staffs, Brill said most of the staff was left feeling ignored by the university.

Before the merger was announced, Brill led a team to identify changes that needed to be made for improved service, but those changes were ultimately discarded in favor of priorities set by Senior Vice President for Enrollment Management and Student Affairs Philomena Mantella, who oversees the health center, Brill said.

Mantella’s priorities included building renovations, handicap access and upgrades to medical equipment. Mantella said she undertook the change to improve an impression she received from campus surveys that Lane Health Center service was “fragmented,” and not up to par.

“I’ve struggled with people’s perceptions that there was poor care, and we set out to improve that,” she said.

Brill said her committee’s work mainly focused on provisions to improve service, but said the health center facility did need updating. She said several changes, including the removal of the center’s X-ray machine, were made that staff believed worked against the goal of more effective service.

Many of their recommendations were completely ignored, said former Medical Director Art Nahill, who resigned in May to take a new job.

“In response to our concerns regarding the need to improve the delivery of care at the university, an outside consultant was hired who amazingly failed to solicit any input from the clinicians at Lane or the Counseling Center and issued a report, the contents of which were never shared with the management of either unit,” Nahill said in an e-mail. “Changes began to occur which seemed haphazard and to oppose the oft-stated mandate of student centeredness.”

Brill said many of the staff members were left befuddled by the change process.

“One would think if an organization wants to change for the better it would commit to using feedback from staff and others for actual improvements, but that was not what happened,” she said. “It was an unusual way to make change.”

The merger also brought the addition of a new executive director to oversee the joint centers, Berrien, who was hired in early 2005. The staff thought the addition of Berrien would allow them to gain a voice with the administration, but several staff members, including former psychiatrist Steve Heisel, said conditions continued to worsen.

As staff began to leave, several staff members said quality of service also decreased. The waiting list of students to see a doctor exceeded 30 at any given point last year, and counselors and medical staff alike were forced to work longer, more grueling shifts.

“It is true of course that should a staff member leave, the others take on the responsibility of the person who has left until we find a replacement,” Berrien said by e-mail. “For that reason, I have spent much of my time recruiting new staff.”

With office morale at an all-time low, exchanges with Berrien started to become more confrontational, the staff said. Staff began to leave meetings with her crying, and some said she embarrassed them in front of students.

Berrien said she had never had an exchange with an employee that ended in tears.

On the other hand, those who remained at their job were faced with more hours for no additional pay.

They were forced to pick up the workload of those who left, Heisel said. Berrien, meanwhile, continued her confrontational style, he said.

Heisel, who left after he absorbed the psychiatry work of two other people in a part-time position, said a response to any opposition to working more hours was often met with statements such as, “Well, we know the people who work in college health.”

“You can figure out [what the statement means], but the implication is not very good,” Heisel said. “If you want a colleague to work more for no more money, in my experience you apologize, you appeal to the greater cause. The card of saying, ‘Well, you’re lazy’ doesn’t win hearts, and is less likely to come up with a solution. One might predict you’d get less good service and less people retaining, and that’s exactly what happened.”

Berrien, who is currently filling the role of executive director, medical director and director of primary care at the center, said she would not validate statements provided to her from staff who spoke on the condition of anonymity. In an interview, though, she acknowledged she had asked staff members to work longer hours and perform tasks they hadn’t before, such as carrying a pager to respond to calls.

“Change is always going to be easier for some people and harder for others,” she said. “Asking people to be available for night call and carry a pager is something that they’ve never done before. Some of our employees wouldn’t work another hour beyond what they were working, so it’s been very hard to fill that need.”

Nonetheless, staff members said they blame Berrien and Mantella’s handling of the merger for the depleted morale.

“Under these conditions, we’re all looking to leave,” said another current staff member, who asked to remain anonymous due to fear of repercussions. “It’s beyond the pale of what we expect to be treated like at this job. Roberta thinks people are leaving because of the merger, but they’re leaving because of her.”

Not every staff member is as quick to blame Berrien. Ed Hattauer, the director of counseling services who departed last week, defended Berrien.

“She has always been very professionally supportive of me,” Hattauer said. He is taking a similar job at Johnson and Wales University in Providence for personal and professional reasons not linked to the merger, he said.

Berrien said she was also awaiting the arrival of a new director of behavioral health to oversee the center’s mental health workers. A new director had been sought by the university for close to three years.

“Although we have had significant staff turnover, there has been a myriad of reasons for this turnover. Some folks have left for personal reasons, some have left for opportunities to advance in their careers, some have left because of the transition,” Berrien said in an e-mail statement. “In addition we have been able to hire excellent new staff including two clinical nurse specialists, our director of behavioral health, a new full-time physician, a full-time nurse practitioner, a part-time general physician and a part-time sports medicine physician, all of whom are highly qualified.”

Mantella said she had experienced similar situations when other offices merged around campus.

“Some people prefer the old system better and some people prefer the new,” she said. “The reality is that we’ve pumped resources and lines into the health center.”

When asked about Berrien’s management style, Mantella defended Berrien, and said she had “not evidenced any style-related issues” when employees were asked to shift their hours or take on more responsibility.

“Consider what taking the department through a change process is like for Roberta,” Mantella said. “Everyone’s saying the change isn’t worth it, and there has been tension.”

Several members of the staff who remain are also concerned about the increasing lack of service the center is providing. Many of the student outreach programs, including drug awareness and sexual assault education programs, and outreach to minority groups have been significantly downsized because of the short staffing, and waiting lists have already mounted in both departments.

“The priority I have to have is on direct service,” Mantella said. “Is it better to have student outreach? Yes, but resources are finite.”

Cuts have also downsized the number of sessions counselors can see each student from 12 to six. One staff member said they would be “lucky to get four or five” sessions.

Elisa Castillo, a former counseling psychologist who left the university to take a similar job at Salem State in August, said she was worried the outreach would not continue with her departure.

“I did a lot of outreach to support students of color and I hope that the university will continue to value this role in the future,” she said.

Her position has not yet been filled, but Mantella said the university was “constantly cranking” to get all the empty positions filled.

Still, some cited an unwillingness by the university to commit to the type of service many at the health center said they were willing to provide.

“It feels like manipulation. The university makes very cosmetic changes, but with completely vacuous service,” said a former staff member, who wished to remain anonymous. “Many of the funds that could go into hiring new staff are put into management positions, yet there is a huge gap in student outreach that needs to be filled.”

And that only adds to waiting lists, staff members said.

“Even with added people, we’re already maxed out early in the year,” said another current staff member who also wished to remain anonymous. “There’s only so many people we can see for clinical work, and cutting off outreach work cuts off another critical piece of what we do.”

Berrien said although there is work still to be done, she is confident the center has had success recruiting new staff to replace those who have left.

“We’re not there yet, but we’re on the cusp of it coming together,” she said.

Brill, who now works at Mount Auburn Hospital in Cambridge, remained skeptical that the center would develop with the level of service she said it once had.

“Now they’re starting from scratch,” she said. “I don’t know if they’ll be able to get people who were as good as they had. It’s going to take a long time.”

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