When it was announced earlier this month that Tony Lourey was Gov. Tim Walz’s pick for Minnesota Department of Human Services (DHS) commissioner, many members of the state’s mental heath and addiction communities breathed a sigh of relief.
Lourey, a four-term Democratic state senator from Kerrick, has a long history of legislative experience working on behavioral health issues. His appointment sent the message to insiders that the new administration understands their priorities and had selected a person well qualified to lead the department on important decisions that touch the lives of many Minnesotans.
Julie Bluhm, executive director of Guild Incorporated, said she thinks Lourey is a good match for the position.
“Tony was a natural pick,” she said. “He’s been an advocate for a long time. He’s been asking the right questions. He’s got the foundation and background that’s really needed to do the job well.”
Sue Abderholden, executive director of NAMI-Minnesota, has worked with Lourey on many legislative issues related to mental health. She said she thinks he’ll lead the department from his deep knowledge of hot topics in mental health — and his built-in empathy for people in need.
Jill Wiedemann-West, People Incorporated chief executive officer, has worked with Lourey many times during his years in the state Legislature. She said she thinks of him as well prepared on the issues, knowledgeable and thoughtful in his interactions with others.
“Tony’s always been very available to folks,” Wiedemann-West said. “He asks good questions because he does his homework. He has opinions, but they come from a good place. He’s a very smart man who feels strongly about doing the right thing. I’m excited about what will come out of DHS under Tony’s leadership.”
Lourey for his part, feels confident that he has what it takes to lead the department.
“This is the space that I’ve dedicated my life to,” he said. “Not just behavioral health but also disability services and health care more generally.”
A little over a week into the appointment, Lourey’s excited about the opportunity and said he plans to settle in and stay long enough to make a significant difference in the state. He’s looking forward to giving the job his full attention and focus, something he says he relishes finally having the opportunity to do.
The appointment couldn’t come at a better time in his personal life, either. “I know it takes time to build these things out, but I’m at a good place in my life,” he said. “My kids are grown. I’m not going to sell my farm, but I’ve got a place down here established. I’m mission focused on getting this done.”
And he already feels comfortable in the job. “I can’t imagine a better space for me personally with my background to really come in and improve the lives of Minnesotans,” Lourey said.
The job comes with a significant level of stress — just ask Lourey’s predecessors — but he said he’s already planning on how he’ll work around that.
“I’m going to take care of myself,” Lourey said. “I’ve done a lot of stressful things in my life. I work hard on self-care.”
Part of self-care is recognizing when it is important to reach out for help. Though Lourey said he hadn’t made a practice of advertising this part of his history, he acknowledged that there have been times when he’s looked for outside support.
“I personally have sought help at different periods in my life when I’ve needed it,” he said. By speaking out about his own story, Lourey hopes to send the message that there is no shame in getting professional help.
“This stigma part, I’m going to help change that,” he said. “I’ve sought help. It is not a sign of weakness. It is a sign of strength. I’m a stronger person because I recognized when I needed help.”
He added that he wants to serve as an example of the power of seeking behavioral health supports.
“My attempt is to get right at the stigma,” he said. “I’m going to own it. I want people to know that if they are struggling we have some amazing supports here in the state that they shouldn’t feel threatened by. When people come forward and ask for help when they need it, it works. It’s very effective and can lead to a much better life.”
Under his leadership, Lourey said that DHS will take a wide-angle focus on the issues. He doesn’t see a clear division between chemical health and emotional health, and he’d like to encourage other people in the state to see it the same way.
“There’s a 70 percent overlap between mental health and addiction,” Lourey said. “If we’re not going to put these two things together we are not going to succeed. We have to have that lens.”
With that in mind, Lourey said he’s chosen to use the term “behavioral health” as an overarching definition of treatments for mental illness and addiction.
“It’s important to think of it as behavioral health,” Lourey explained. “So much of chemical dependency is self-treatment for mental health. We need to recognize that. The overlap is natural.”
Lourey said he thinks that it is important to get people the services they need early, before they reach a crisis point. This means further investment in first-episode psychosis treatment programs, in chemical health assessments, and in mental health education and crisis programs.
“We’re going to get people services earlier,” Lourey said. “We are going to make sure they get the right service at the right time in the right setting. I’m putting that up on my board. There are so many strategies to achieve these broad-outcome goals. If we keep our focus there that’s how we succeed.”
In line with Walz’s “One Minnesota” platform, Lourey said he would also like to renew his department’s focus on behavioral-health parity, or ensuring that all Minnesotans, regardless of race, gender or socioeconomic status, have equal access to the range of supports available around the state.
“One thing we have to work on in the behavioral health space is our disparities,” he said. “We have some good stories and good statistics, but underlying each of those are really alarming, widening disparities statewide.”
Lourey is also interested in expanding supports for programs that he thinks are working well. He praised the “whole-person” approach to mental and physical health embraced by the state’s certified community behavioral health clinics (CCBHCs).
“I’d like to give a shout out to our CCBHCs,” he said. “They are transformational in combining physical health and mental health together and focusing on the whole person. Hats off to the systems that have taken the risk and stepped up into this space.”
The risk that Lourey is talking about stems from the fact that much of the funding for CCBHCs is currently grant-based. This means, he said, that investing in these types of programs requires a “leap of faith,” because long-term funding is not guaranteed. He’d like to change that.
“I’ve visited several of these clinics and seen the impact they have on people,” Lourey said. The comprehensive approach of providing a range of care opportunities for patients in one space seems to be working, especially in the state’s most vulnerable communities: “We have to take a look at what works and make sure we are willing to put sustainable money behind models that work.”
Supporting models that work requires focused attention and collaboration with professionals who work on the ground with the people who are most impacted by legislative decisions. Lourey said he plans to encourage a department-wide focus on open communication with members of the community — from nonprofit leaders to everyday people with skin in the game.
“I just did an employee forum,” Lourey said. “There were 150-200 DHS employees there. I said, ‘We are going to be more open and transparent. Not every good idea comes from DHS. We are going to go out into the communities and engage and find good ideas from there.”
Response to controversy
One of the first things that Lourey hopes to address in his new role is the slight sting his department is feeling from community response to the state’s decision to end the competency restoration program, a program designed to help criminal defendants with mental illness achieve the competency required to stand trial.
Under this decision, announced in December, many defendants who were being treated at state-run psychiatric hospitals like Anoka-Metro Regional Treatment Center will be transferred back to county-run jails, where officials say their treatment will continue. Advocates argue that jails are inappropriate settings for psychiatric treatment.
The announcement of changes in the program was communicated through a letter and a bulletin to stakeholders. Many of the state’s mental health advocates, including Abderholden, felt that their opinions were not taken into account in making the decision and the manner in which the announcement was made felt abrupt and non-collaborative.
While competency restoration programs are being shut down across the country, Abderholden said that she had hoped Minnesota might find a different solution through consultation and compromise.
“If you are going to solve this problem you have to bring everyone together,” she said. “This is a tough issue. You aren’t going to solve it by just issuing a bulletin. That’s not fair to people.”
Lourey agrees that news of the program’s cancellation could have been released differently. “I don’t think the communication was handled in a very productive way to accommodate this change,” he said. “If we had been more clear about these changes ahead of time and built in some transition to better serve their needs it would have been better received.”
But he does believe that there is good reason for shifting some people in the program back to county settings.
“Early on I said, ‘We need to use our clinical beds appropriately.’ For 75 percent of the population that comes in for competency restoration, the educational piece is met concurrently with improvement in the clinical sense. There are people for whom this isn’t the right space.”
Abderholden said she hopes that under Lourey DHS will take a more collaborative approach to decision-making on major issues like this one.
“We’re hoping this is going to be a different administration,” she said. “It’s been stressed by the governor that they are going to reach out and work within the community to make sure they are serving people, and it would be great to see it start at DHS.”
Lourey said that his abiding interest in supporting the behavioral health of others is a natural result of growing up in a large, diverse, blended family. He never made a point of talking about it in his political campaigns, but he credits his parents, father Gene, and mother Becky, a former gubernatorial candidate, state representative and senator who raised him along with 11 siblings, as the inspiration for a career in public service.
“I grew up on a farm two hours north of the Twin Cities in a really interesting family,” Lourey said. “My family was built by birth and adoption. We had four biological siblings and eight adopted siblings. Each of my adopted siblings had challenging stories and came from all over the world. Growing up together taught me so much empathy and understanding about the interactions of people with community and systems.”
The supports his siblings and parents received, and the love they all shared as a family demonstrated to Lourey that there is an innate interconnectedness among people of all racial and ethnic backgrounds.
“From a very young age,” he said, “I heard powerful stories that were part of my family and my loved ones. Here I was, a little white farm kid who otherwise would have had a pretty narrow world view, just opening up to these stories and bringing this diversity into our community and finding the strength to help support that. We had a lot of successes — and we had a lot of really challenging experiences as a family, too.”
Lourey said that he and his wife, Marlana, wanted to replicate some of that expansive approach to parenting as they started their own family.
“My wife and I built our family by birth and adoption as well,” he said. “We have two biological kids and one adopted daughter who is disabled. We have lived this and see the challenges that people face. It’s something that I’ve invited into my home and my loving space for my whole life.”
Lourey said he plans to draw on this unique perspective in his role at DHS. He understands that the world is larger than what most people see when they look out their window, and he hopes that understanding will inform his decision-making for years to come.
“I can’t imagine a better space for me personally with my background to really come in and improve the lives of Minnesotans,” Lourey said. His unconventional childhood, he believes, “built in me a profound understanding of the power we have when we invest in the health of our people, our families and our communities and find those strengths that exist and use them to help fill the gaps.”