Robert M. La Follette School of Public Affairs
Wednesday, January 18, 2012

Gross uses system to improve mental health services


Shel Gross

Structural change takes a long time, and success depends on the many people with a stake in the system.

1990 alum Shel Gross keeps these tenets in mind every day as Mental Health America of Wisconsin's director of public policy. In that position, he leads systems-level advocacy around mental health issues. A recent achievement was Wisconsin's passage of mental health parity legislation.

"I began working on mental health parity to require insurance companies to cover mental as well as physical health in 2000, when I started with MHA, and it only passed the legislature in 2010," notes Gross, a registered lobbyist who works with the legislature and state agencies. "But, as you would imagine, there were a lot of people required to make that happen."

Involving stakeholders, especially people who use services, is key to improving public policy and mental health services and practices, Gross says. As chair of the Wisconsin Council on Mental Health, he is part of a two-year effort to set priorities for services in Wisconsin. "Although the council is advisory, I think we have done a good job of using its structure to bring together the main players in the mental health system, including consumers and family members, to define common priorities and goals," Gross says. "Because of changes at the federal level, we need to undertake a strategic planning process over the next 18 months, and I think the consensus-building we've been trying to do will facilitate that. The fact that I've always been good at the big picture stuff and working with a wide variety of stakeholders will help me as I lead the council through this process."

In addition to Mental Health America of Wisconsin's public policy issues, Gross handles public education, which includes reducing social stigma, promoting workplace mental health practices and preventing suicide.

To emphasize the importance of understanding the causes of mental illness, mental health advocates had declared the 1990s to be the Decade of the Brain. However, when Gross started at Mental Health America of Wisconsin in 2000, the national organization's president suggested in a speech that "the first decade of the 21st century be the Decade of Social Justice to underscore the fact that people with mental illness still had very limited access to treatment services and, as a result, were more likely to be poor, homeless, incarcerated and unemployed," Gross says.

"To me the work I do is about social justice," Gross says. "Because social justice strengthens our society, seeking it is a form of public service. Although I'm in the private sector now, my work clearly impacts the public sector."

Gross collaborates regularly with his public sector colleagues to educate people and advocate for improved mental health services. Since 2004, he has headed Mental Health America of Wisconsin's effort to build a statewide infrastructure for suicide prevention. Gross and Mental Health America of Wisconsin won a $1.1 million, three-year grant from the Substance Abuse and Mental Health Administration of the U.S. Department of Health and Human Services in 2006. Gross served as project manager for the grant, which was focused on youth suicide prevention.

"This grant allowed us to build on earlier work and provide resources, training and technical assistance to support the development of local suicide prevention coalitions across Wisconsin," Gross says. "We also work with state systems, such as public instruction and child welfare, to enhance the ability of people working in those systems to recognize and respond to individuals who may be suicidal."

Gross' ability to work with a variety of stakeholders facilitated his role as one of the founding board members of Wisconsin's statewide mental health consumer group, Grassroots Empowerment Project in 2001. "I was the only non-consumer on the board," he says. "I have always felt honored that the mental health consumers had that type of trust in me." In November, Gross was recognized by Wisconsin mental health consumers at their annual conference with a new award for "Kindling the Spirit of Recovery."

Prior to joining Mental Health America of Wisconsin in 2000, Gross worked for the Wisconsin Department of Health and Family Services for 10 years as the mental health and substance abuse planning analyst in the Wisconsin Medicaid program. In this capacity Gross developed and implemented policies around Medicaid coverage for mental health and substance abuse services. He oversaw the establishment of new community-based services, including community support programs for adults with mental illnesses and in-home treatment for children with serious emotional disorders.

Gross' prior experience and work at the La Follette School led to the DHFS job. "Working in the mental health system, I became fascinated by the role that public policy played in whether and how people's service needs were met; that was my impetus to enroll at La Follette," he says. "In just about every class where I had the opportunity, my papers or projects would revolve around mental health and how services were funded. My internship in the Medicaid program at DHFS during my tenure at La Follette turned into a job, a perfect fit as it turned out. I was able to do to help develop new funding options for Medicaid to address some of the deficiencies in Medicaid mental health funding. And we're still working on how funding can support the services that consumers want; for instance paying for peer run or peer-delivered services."

Gross appreciated the variety of students in the public affairs program. "A number of folks like myself had real-life work experience," he says. "We had one state legislator in one of my classes, as well as individuals with public policy experience. It brought a very pragmatic aspect to the discussions we had in class. It wasn't just theory; it was about the way things worked in the real world."

The quantitative training has been useful, Gross adds, even though he does not do much direct research and analysis. "You've got to know this stuff so you can understand when and how opponents are twisting the numbers and the research," he says. "And, of course, you need to know how to represent those data that support your own position. I can hold my own in analyzing and interpreting data. I have to read a lot of research so those skills serve me well."

— article last updated January 18, 2012