Can you remember the last time you made a promise? Outside of our marriage vows, most of us do not like to think much about promises because they remind us of our past failed personal attempts to watch less television or to floss with more regularity. Despite our best intentions, if given the option to take the easy road or the hard road in life, we all tend to revert back to the path of least resistance.
Stephanie Pate Greer, the Director of Behavioral Health at Appalachian Regional Healthcare System (ARHS), knows firsthand the danger of complacency. She and her team of nurses, therapists, crisis interventionists and psychiatrists have made a collective and unwavering commitment to always provide high quality behavioral health services in the High Country. For Stephanie, it was a promise made in heartbreak, steeped in love and maintained by her uncompromising resolve.
It takes a village
Stephanie could run the cash register and count back change at 6 years old. It was at her mother, Geneva Pate’s side that she proudly learned the fundamentals of customer service while working at Pope’s Family Center in Newland, NC. In a town with only two traffic lights, she quickly became well-acquainted with everyone in her “Mayberry-esque” community. Between customers she liked to spend her hard-earned wages on peach Nehi and Whatchamacallit candy bars from the neighboring Avery True Value Hardware store.
She also enjoyed spending quality time with her father, Dallas, a retired North Carolina State Trooper, who she considers to be the most influential person in her life. Some of her fondest memories took place in his patrol car, where she was allowed to run the radar detector, wear his trooper hat and just spend quality time with her favorite law enforcement officer.
“While we were ‘out on patrol’ dad also taught me a lot about life,” she shared. “Integrity was very important to my father. He taught me that in this life we are not entitled to anything. But with hard work, we can absolutely accomplish whatever goal is set before us. He also taught me that your word is your bond and that a promise made should be a promise kept.”
Stephanie was named Most Spirited in her high school annual. It was there that she competed in softball, cheerleading, public speaking and in other events as a part of Future Farmers of America, Fellowship of Christian Athletes, Future Business Leaders of America and in the Student Government Association.
She credits her zeal for life to her faith in God. “I think it is a normal part of human behavior to mess up from time to time. But when you discover that you have a God that loves you, and literally a village of people like ours supporting you, I think it brings out the best in people.”
Throughout high school and college Stephanie worked on Grandfather Mountain. It was there that she started in the gift shop and then transferred to the role of zookeeper. In that position, she was tasked to take care of the black bear, cougar, white-tailed deer, golden eagle, and bald eagle habitats.
“Little did I know it at the time, but learning how to change my demeanor to accommodate where I was proved to be great foundational training for the work I do today in behavioral health,” she said. “I’ll never forget the first time I went into the cougar habitat. I was told to expect the 115-pound cat to pounce on me. I was told to face the cougar and to knock the animal back; this would in effect quickly establish who the alpha was in the situation. Sure enough, the cat leapt and I did everything wrong. I turned my back and screamed. I think we all do that at some point in our lives.”
Determined, she went back to the cougar habitat a few days later to face her fears. This time, when the animal pounced, she held her ground – a lesson learned and a fear conquered.
Lost and found
Stephanie’s interest in healthcare developed after she injured her knee cheerleading and had to endure multiple surgeries followed by physical therapy. Inspired by her own healthcare experience, she went onto Western Carolina University to study recreational therapy.
Her program required a four month onsite clinical internship. Stephanie chose to complete her internship at Broughton Psychiatric Hospital because it was close to home and more importantly close to her parent’s refrigerator.
“I was the first intern allowed to work on the adult acute-care admissions unit,” she said. “I learned quickly that at a state psychiatric hospital you see people at their lowest and sickest points. I also learned that there is absolutely no difference in the human beings in need of behavioral healthcare and you and me save a few circumstances. Circumstances could be life or chemical related, but they are still just circumstances. They are still people. A group of people grossly misunderstood and under advocated for. I had found my passion.”
Stephanie was hired as the recreational therapy supervisor for adult acute-care admissions at Broughton Hospital when she turned 21. Admittedly, it was a big job, and she leaned on her more seasoned staff to help her develop new programs, such as the first treatment mall, a school equivalent for patients suffering from mental illness. During that time, she was promoted several times and she went on to complete her Master’s in Business Administration at Gardner-Webb University.
Her hardest lesson learned however took place one day when she heard screams coming down the hallway of her unit. She raced to find a patient who had committed suicide on her watch. Devastated, she admitted to the patient’s family that despite checking-all-of-the-boxes in terms of safety and therapy, she viewed it as a personal failure. Through tears she made a promise to herself and to that patient’s family that she would never again be satisfied with just checking the boxes.
“By the very nature of working in behavioral health, you know that things like this can happen,” she shared. “But we have to be vigilant to guard against it. We can never be content or complacent. I made a promise that day and I was determined to keep it.”
After months of mounting pressure from a family friend, Stephanie finally agreed to go on a blind date with Allan, a Boone Police Officer.
“I was so nervous about the whole blind date thing that I made Allan pick me up from my parent’s house,” she said. “He then took me to see a church play, I figured that was a pretty safe first date. We got married a year later and never looked back.”
Fast forward 10 years. Allan had become a State Trooper, Stephanie was well entrenched in her role at Broughton, they now had two children and were “settled” in every sense of the word when she received a call from a headhunter in Arizona to inform her that a Director of Behavioral Health position had opened in Linville, NC. Assuming that she was unfamiliar with the area, the recruiter went on to try to “sell” the mountain community to his client. Stephanie smiled in a moment of serendipitous delight at the thought of returning home to her beloved Avery County.
She was hired for the position at Cannon Memorial Hospital by Carmen Lacey, now president of the hospital and a lifelong friend; and Chuck Mantooth, President and CEO of ARHS.
“I’ll never forget my first day on January 27, 2008,” she said. “It was an ice-storm and everything in town had shut down, but I knew that I had to get to work, especially on my first day by 8 a.m. So we parked my car at the bottom of our hill the night before and I made it in on time, an hour before everyone else. I guess you could say that I was eager to get started.”
Meeting a need
And so it was that the behavioral health department formed at ARHS. Within her first year she reopened a 10-bed inpatient behavioral health unit in the hospital. This unit is fully equipped to provide psychiatric evaluation, medication management, individualized treatment planning and group therapy.
She also revamped outpatient behavioral health services to improve access to adult, child and family therapy. The outpatient program started with 12 patients and now maintains a caseload of more than 1300 individuals from across the High Country.
She then launched the Behavioral Health Crisis Team in 2011. The mobile crisis team is designed to meet and treat patients at whatever point they access the healthcare system. In many cases, the crisis team has saved patients from having to incur costly and unnecessary emergency department visits.
Despite these milestone achievements, the demand for behavioral health services continues to rise in North Carolina. As the only inpatient behavioral health facility within a 40-mile radius, Cannon Memorial Hospital receives more than 5,000 psychiatric referrals from across the state each year. Of those, the hospital is only able to admit an average of 560 patients into its 10-bed inpatient unit.
To help meet this need, the North Carolina Department of Health and Human Services (NCDHHS) recently awarded Cannon Memorial Hospital with a $6.5 million grant, to expand the availability of behavioral health beds in the western region of North Carolina. The funding for this grant originated from the Dorothea Dix Hospital Property Fund, which was created by the North Carolina General Assembly from the sale of Dorothea Dix Hospital in 2015.
“This grant was an answered prayer for our community,” she said. “Not only does this create an opportunity in Avery County for us to continue to meet the medical needs of the community, but it also allows us to have an opportunity to expand and improve access to much needed behavioral health services.”
After months of careful planning, construction began last month to expand outpatient behavioral health services. Additionally, the grant will be used to create a designated 37-bed inpatient psychiatric unit within Cannon Memorial Hospital.
Thanks to other funding sources, the medical side of the hospital is also getting an upgrade. Once the two-and-a-half year construction project is complete, Cannon Memorial Hospital will operate as a Critical Access Hospital, fully equipped with a state-of-the-art inpatient 8-bed medical unit to meet the needs of the community. In addition to behavioral health services and inpatient medical care, the hospital will continue to provide imaging, laboratory, primary care, surgery, rehabilitation and cardiopulmonary services. This full-service medical campus will continue to serve as the hub of healthcare in Avery County.
“I live less than a mile from here,” she said. “So it goes without saying that it is important for me and my family to have access to good medical services. In a community of our size, it is unheard of to have access to primary care, preventative health and wellness care, behavioral health care and all of our specialty care. It is truly a blessing that I don’t think people in our community fully grasp.”
For Stephanie, everything goes back to that little girl behind the cash register with her mom. At an early age she fell in love with this community and she takes great pride in providing for its needs.
“My hope and prayer is that as we grow our services, the High Country will come to see that these patients are nothing more than our friends and our family members,” she said. “Unlike every other diagnosis, there seems to be a stigma or fear to talk about behavioral health. But the truth is that one-in-four adults will suffer every year from a diagnosable mental illness. Our goal is to meet these people where they are and to provide them with the care they so desperately need.”
In her office you will find motivational quotes hanging on the walls and pictures of her children prominently displayed on her bookshelf. She is proud to share that Zack, her oldest, is considering a career as a physical therapist. And that Reagan “Bob”, her 12-year-old daughter, has her mind set on following in her mother’s footsteps and becoming the next director of behavioral health at ARHS. It is clear to see, that like the rest of us, her children admire their mother’s heart and passion to serve others and have been positively affected by having the opportunity to be nurtured in the same “village” of people their mom did so many years ago.
In this line of work it is not about perfection, it is about progress. We do what we do in behavioral health because we love our patients. It is hard to describe just how blessed I feel to work here and to give back to the very community that has given so much to me.”