David Evans integrating mental health into health care

CEO of Austin Travis County Integral Care also heads New Milestones Foundation

During the 1960s, a young David Evans opened up child care services at public housing in Pontiac, Mich.

“One thing I learned was grace matters,” the Austinite says. “They took care of me during the day, but you are on your own after dark. I also learned that, not only does poverty have social consequences, but certainly in that area, there was a high correlation between race and poverty.”

Now CEO of Austin Travis County Integral Care, which provides services for those with behavioral health problems and developmental disabilities, Evans began to think about racism and intolerance by way of immersion. As a volunteer for newly-created VISTA, the domestic version of the Peace Corps, the Detroit native never stopped asking questions about the junction of poverty and need.

His focus these days is mental health care as part of overall health care. He’s also the CEO of the New Milestones Foundation, which raises private money for those served by Integral Care.

Thursday, the group will hold its annual benefit at the Four Seasons Hotel, where journalist Tara Ebrahimi will talk about her family’s encounters with emotional disorders.

Evans, 65, was reared by a blue-collar family in patriotic Oakland County outside Detroit.

“We were told it was the best county in the country,” he recalls. “Detroit was a great city. We had the Great Lakes. We were on the right side of the Civil War. I grew up thinking we had great public schools, unions, suburbs.”

Like many kids in the 1950s, Evans spent most of his free time outdoors.

“I’d leave early in the morning and come home late at night, exhausted by playing hard all day,” he says. “”We camped out behind the house. Back then, baseball was the great American sport. I also played football and basketball, then rugby in college. I once traded a really fine baseball glove for a really lousy guitar.”

This upbeat life changed permanently when his father was nearly electrocuted working on high-power lines.

“That was a turning point,” Evans says. “He never found his footing again. We later recognized that he went into a severe depression. I was away at college. He died my freshman year.”

Evans dropped out, but his mother convinced him to stay the course to finish the study of psychology at Michigan State University. By then, the entire country was undergoing violent alteration.

“I was deeply affected by the Vietnam War,” he says. “So I hitchhiked to San Francisco. I wanted to see for myself what was happening.”

After that pilgrimage, Evans returned to his studies. During a time of decaying urban schools and white flight to the suburbs, he earned his master’s degree from Oakland University back in Michigan, then went into teaching. But the 1973 oil embargo and the subsequent auto industry bust forced the school district in Pontiac to lay off all first-year teachers.

He took odd jobs in group homes and for drug hot lines. Ten years earlier, the Community Mental Health Act of 1963 had decentralized care and created a need for small group homes to serve those with mental illness, developmental challenges or problems with drug abuse. At age 33, Evans rose to state director for community health services in Lincoln, Neb.

After nine years at that job, he was offered a similar position in Atlanta, where he oversaw 19,000 employees and helped pass laws that completely reorganized mental health services there.

Eventually, the father of four migrated to Austin.

“I’ve been trying to progressively improve mental health care here for 20 years,” he says of his work at Integral Care, which oversees services at 45 locations in Travis County with a staff of 650. “Is it boring? No!”

Evans has witnessed a sea change in the treatment of those his staff and volunteers help.

“We now have a clearer understanding that mental health disorders, substance abuse and developmental disabilities are brain-based disorders,” he says. “We used to think these folks had bad characters, had criminal intentions or were sociopaths. Because we learned about them through movies and the media.”

In fact, Evans intervened when someone proposed screening “The Texas Chainsaw Massacre” at the old Austin State School.

“This will put us back 20 years,” Evans argued. The screening was canceled.

A huge push for Evans nowadays is getting insurance companies and Medicaid providers, along with clinical physicians and nurses, to take into account psychological signals.

“Say a woman comes into a well-child program and gives waxy answers,” he says. “What should a physician do? Call in a consultant to see if she’s suffering from postpartum depression and start treatment.”

He says Austin is actually in front of the game through coordination with groups such as New Milestones, Seton Family Healthcare and Central Health.

“Mental health issues have been a sleeping giant,” Evans says. “The awakening is seeing the need to provide access, address stigma and know that mental health is essential to health.”

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