Dr. Joseph Bevilacqua: An Impressive History of Service to the Mental Health Community

Dr. Joseph Bevilacqua in his Little Compton, Rhode Island home

Over the past fifty-five years, Dr. Joseph Bevilacqua has blazed an impressive path as a pioneer of equality in mental health care and consumer rights. A native of Elmira, New York, his notable service to the mental health community includes his appointment as Director/Commissioner of Mental Health and Mental Retardation in three states: Rhode Island, Virginia, and South Carolina.

Dr. Bevilacqua began his social work career in 1955 as a Program Director at Father Baker’s Home for Boys in Lackawanna, NY, and received his Master’s Degree in Social Work from the University of Buffalo that same year. He returned to academia in 1967, earning his Ph.D from Brandeis University, Florence Heller School for Advanced Studies in Social Welfare. Along with his clinical positions, which include military psychiatric work through the late 1960s and early 1970s, Dr. Bevilacqua taught at the National Catholic University School of Social Service, the School of Social Work at Virginia Commonwealth University, and Brown University. Dr. Bevilacqua has been a consultant to, and a member of, several influential task forces and committees, including the President’s Commission on Mental Health-Task Force on Organization and Structure of Mental Health Services (1997-1998). He has served on the board of many influential mental health agencies, including his two-year tenure (2000-2002) as Board Chair of Fellowship Health Resources (FHR/Fellowship).

As an advocate for FHR, I was interested in finding out what prompted Dr. Bevilacqua to get involved with Fellowship Health Resources. He stated, “The Fellowship is an example of the sort of grassroots developments we saw in the seventies, and I think it has made the case for integration into the community and community care.” The invitation to serve on the Board came directly from FHR’s President and CEO, Joseph Dziobek. The two had forged a relationship years earlier through their common goals in restructuring Rhode Island’s mental health services. When Dr. Bevilacqua returned home to Rhode Island, Mr. Dziobek saw a golden opportunity to invite him to serve on Fellowship’s board.

Earlier this year, I sat down with Dr. Bevilacqua at his home in Little Compton, Rhode Island, and tapped into his wisdom and experience on matters relating to mental health, the state budget, and the nation.

Having served as the Director of Rhode Island’s Department of Mental Health, Retardation and Hospitals (MHRH), from 1975 until 1981, Dr. Bevilacqua was present when, in 1975, then Governor J. Joseph Garrahy, removed the bars from the state hospital windows. Fast forward to 2008 and the passage of the Mental Health Parity Act.* I asked Dr. Bevilacqua to share his insight on the current situation for mental health service recipients and providers. “We’ve come a long way in terms of how we understand (mental) illness and how we treat it,” Bevilacqua began. “The basic health care system has a better understanding of mental illness than it did when I was just starting my profession, so that’s a plus, I think. My sense is that we have definitely improved how both the patient and the doctor understand what is out there for treatment. There is an acceptance that did not exist in the past. I think we recognize and understand mental illness as an issue in a way that we did not before. I feel this is due, in part, to the advocacy of consumers and family members, and I think that advocacy has helped mental health professionals and legislators to be more honest in how they address these issues. I have also witnessed an increase in the number of consumers and family members advocating for change. You cannot deal with the politics of it all unless you have the support of family members who are willing to walk the street and make the case for change to members of the general assembly. Back in 1975, we had very little political entrée. Fortunately, that has changed.” Bevilacqua also credits the positive changes in treatment, resulting from early intervention and the strong support of national agencies, with helping to lessen the sting of stigma associated with having a mental illness.

Despite all of the aforementioned positive changes that Dr. Bevilacqua has seen and been an active part of over the years, he feels strongly that there is still plenty of room for improvement. Aware that there are still significant problems with the shortage of funds existing today, Bevilacqua notes one, perhaps crucial, difference with the present system. “It may be harder today to initiate change,” said Bevilacqua. “Decades ago, we had a momentum nationally to depopulate the state institutions. In spite of efforts such as the recent change in the laws over mental health parity, national momentum for mental health improvement has waned.”

Although Dr. Bevilacqua is somewhat pessimistic in his short-term outlook regarding the current state of Rhode Island’s financial crisis and its effects on the future of mental health care, he remains positive that, in the long-term, we will come back. “Things locally, as well as nationally, are such that it’s about reducing spending. When that happens, issues like mental health suffer. We don’t have the priority,” he lamented. “However, in the long-term I think we’ll see a more equitable distribution of resources for our interests.”

Dr. Bevilacqua continues to work tirelessly to gain a national momentum to bring the focus back to equality of services for the mentally ill. As current Chair of the Corrections Mental Health Committee, he is especially committed to changing the shape of the future for prisoners with mental illness in Rhode Island. “We’re concerned with the number of people in corrections who are mentally ill and do not get direct treatment for their illness,” he said. “We’re trying to better understand why this is the case and learn how we can do a better job.” For Bevilacqua, this is a major priority that needs addressing. “We have too many people in prison that really shouldn’t be there.”

Other changes Bevilacqua would like to see center around the relationships of agencies such as the State Department of Children, Youth, and Families (DCYF) and the Department of Mental Health, Retardation, and Hospitals (MHRH). The current process is one of referral, primarily to collaborating agencies; however, the shortage of child psychiatrists and other properly trained mental health workers has been an issue for the nation as a whole when dealing with children. “We often miss the mark on picking up on cues with our state’s children,” he began. “Perhaps if a child is diagnosed as mentally ill, mental health agencies should have the responsibility of taking care of that child rather than DCYF, which may not have the resources to understand how to deal with the diagnosis properly.” Bevilacqua continued, “There is a lot of fragmentation, which I think delays service and treatment, which is, of course, not good.”

Bevilacqua continues to use his highly-developed administrative and political skills to achieve improved care for those who need service. In addition to his position as Chair of the Corrections Mental Health Committee, he serves on the Board at the Poverty Institute, the Human Services Research Institute in Cambridge, MA, as well as the Mental Health Association. He is a trustee for the Seven Hills Foundation and Affiliates, a psychiatric and disability service system working in Massachusetts and Rhode Island. His writings include a publication reflecting some of his pioneer work in Rhode Island entitled, “Changing Government Policies for the Mentally Disabled.”

By:  Ed Allard, FHR Communications Representative

* The Paul Wellstone-Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (HR 6983) requires group health plans to cover treatment for mental illness on the same terms and conditions as all other illnesses.