Audrey Burger, clinical operations director for the Community Counseling Center, discusses the mental health field

In 18 years in the mental health field, Audrey Burger, clinical operations director for the Community Counseling Center, has seen her share of changes. A heightened awareness of mental health issues means people are seeking help at a younger age.

Last year, the center broke ground on a $1.5 million expansion, a project made necessary by the increase of people seeking help at the center. The expansion will include a two-story, 9,500-square-foot building to connect with the center's existing facility at South Silver Springs Road and Bloomfield Road n Cape Girardeau. The new building will house administrative offices, psychiatric day treatment programs, consumer employment services and forensic services.

Audrey and her husband, Philip, live in Perryville, Mo. "Philip and I love to go four wheeling with our friends," she says. "We have two grandchildren who we and adore and try to spend as much time with as we can. They are the love of my life, and being a grandma (Mima) is the ultimate success of my life."

Here, more about Audrey's experience in the mental health field and the work of the Community Counseling Center:

BT: Tell me a little about where you grew up and your educational background.

Burger: I was raised in St. Mary, Mo. I received my undergraduate bachelor's degree in social work from Southeast Missouri State University and received my graduate MSW degree from SIU in Carbondale, Ill.

BT: How long have you worked for the Community Counseling Center? How long have you worked in the mental health field?

Burger: I have worked for Community Counseling Center for approximately 18 years. I started out working as a family assistant worker, then coordinator of our children alternative services, director of children services, regional director and now am the clinical operations director. My focus has always been mental health. I have a great passion for the field of mental health and the desire to help people access services they need. In 1990 my brother and then two very dear cousins completed suicide; mental health has always been where my heart is.

BT: Can you update us on the CCC's expansion?

Burger: Exciting things are happening at Community Counseling Center. We have just started building a substance abuse component to deal with our dual-diagnosed clients. We are bringing up the IDDT (Integrated Dual Diagnoses Treatment) program. When the Department of Mental Health closed the Farmington, Mo., hospital, we were given the opportunity to create programs to shorten or avoid hospitalizations. One such program is our diversion beds, which are designed to divert persons from hospitals or to allow persons to be discharged early from the hospital. Along with this we started a day treatment where people who are experiencing problems associated with their mental health can come daily to get an intensive treatment so as to avoid hospitalization or to stabilize their symptoms. We have just expanded this program to include co-occurring treatment. We are bringing up a psychosocial program (PSR JR.) for the children. We have a program for the adults, but this is for the children we serve in our community-based programs. It will be a day program or evening and weekend program to work with children who have mental health issues. We have brought up an individual placement service program (IPS) to assist our clients gain competitive employment. We partner with vocational rehabilitation services to provide this program. It involves developing work sites in the area which will hire persons with mental illness. To date we have had success in finding employment for our clients.

Another important area we have been working on is the Crisis Intervention Team (CIT). This is a law enforcement program that works closely with the mental health agency. The idea is to train law enforcement on mental health issues and try to avoid some of the frustrations and other issues law enforcement has when they encounter persons with a mental health problem. The Cape police academy will bring the 40-hour-a-week training to offer to law enforcement and from there an advisory board will be formed so we can staff difficult cases and work closely together to problem solve some of the more difficult cases.

Another new program is our school-based therapy. We have just begun to work with schools in our area on providing a therapist to actually go into the schools and help identify children who need mental health services and provide therapy to those who need it. Cape, Jackson, Ste. Genevieve and Madison have all signed MOUs to begin this service. This is exciting because if we can get the children into services and provide services then the hope is we might avoid some of the more serious issues that develop when mental health issues go untreated. Also, along with our Lou Masterson residential home, we brought up the Ridgeway home to provide community treatment to women who have been in mental health institutions for long periods of time. The idea behind this is that treatment is more effective if you can provide it in as natural a setting as you can versus providing it in an institution setting.

BT: It has been previously reported that expansion is necessary because of the increase in the number of people seeking help at the center. What are some of the factors contributing to that increase?

Burger: Many factors play a role. Our agency has offices in each of the five counties we serve, giving people access to needed services. I believe the programing we offer meets the needs, so people seek services out. I also think in the last few years with all the horrible tragedies which have occurred in the country, the awareness on mental health issues has been heightened.

BT: I know the center offers a variety of services: What are the ones most commonly sought out?

Burger: Crisis services keep us extremely busy. We provide crisis services seven days a week, 365 days per year. Every day, people walk into our doors looking for help to ease their pain. From there, many times a referral to outpatient therapy or an appointment to see one of our doctors is made. We certainly refer to any other program that might help the people we see. We have just begun to assist people with Medicaid applications. With all the local family support offices closing, sometimes people were not able to access the application, so we help them fill out the application and walk them through the process.

BT: How has the attitude toward people seeking mental health changed over the years?

Burger: Mental health stigma is still something we confront daily. While persons with mental health are more likely to become a victim of crime, the past tragedies that involved persons who suffered with mental health issues have brought a heightened awareness to persons with mental illness. People have a tendency to fear what they don't understand. I believe recent legislation has moved toward attempting to fund treatment of mental illness to the degree it needs to be. but much more needs to be done.

Another way we try to combat stigma is through our Gallery of Inspiration. It is a consumer-run art gallery downtown that displays beautiful and interesting works of art created by persons with mental illness. It is often through the artwork they create that their story is told with such deep passion. Their art work is displayed and sold at the gallery.

Another way we combat stigma is with our new program Individual Placement Services (IPS). We have found upward of 20 or more consumers competitive employment. Employers have told us that the dedication of these workers is amazing. One employer told us if it hadn't been for the IPS employee, he probably wouldn't have passed an inspection. Now that is a testament of breaking the stigma and negative attitudes of persons with mental illness!

BT: How has the mental health field changed? It seems services are more readily available. Is that true? If so, what do you think has lead to that change?

Burger: In my 18 years working in this field, I believe I have seen a change in the age of children who seek out treatment. It used to be rare if a 6-year-old came to us, but that is not uncommon any more. Services are more readily available because we have had to be creative in our approach of service delivery. For example, when the Department of Mental Health decided to get out of acute hospitalization, we had meetings with other service providers in our five-county area to discuss collectively what our region needed to address this situation. Out of that, the state made available funding for us to open up the diversion beds, day treatment and the Ridgeway home. We meet yearly with community partners to discuss needs. Just last year law enforcement expressed concerns about not knowing or understanding how to deal with persons with mental health and their frustrations about the hospitalization process. This is why we are bringing up the Crisis Intervention Team (CIT) to provide training and support to our law enforcement. The governor also provided funding this past year to provide each community mental health agency in the state a Community Mental Health Liaison to work exclusively with law enforcement and help problem solve some of the more difficult cases they encounter. However, having said all that, there still isn't enough funding to provide what is truly needed.

BT: Is there anything else you would like to add about the CCC and its services?

Burger: I am extremely proud to work for an organization that turns no one in need away, whether they can pay or not. This agency's commitment to the communities we serve is amazing. Most people don't even know the magnitude of impact that Community Counseling has on their community. The dedicated, compassionate professionals I have the honor of working with do it with such commitment and passion. I have sat in staffing and seen the tears of staff who feel so deeply for the people we serve, yet every day they come to work and give it all they have just to make life bearable for the people we serve. We have great successes, as people can reach recovery however they define it. We rejoice with the people we serve and feel honored they allow us into their lives.