Q&A: LifePath Systems CEO Tammy Mahan speaks on caring for Collin County during COVID-19

Tammy Mahan started as LifePath Systems' CEO in February. (Courtesy LifePath Systems; Designed by Chelsea Peters/Community Impact Newspaper)
Tammy Mahan started as LifePath Systems' CEO in February. (Courtesy LifePath Systems; Designed by Chelsea Peters/Community Impact Newspaper)

Tammy Mahan started as LifePath Systems' CEO in February. (Courtesy LifePath Systems; Designed by Chelsea Peters/Community Impact Newspaper)

Tammy Mahan began her role as the new chief executive officer of LifePath Systems in February, just before the coronavirus pandemic arrived in Collin County.

LifePath Systems serves the mental health and intellectual and developmental disability needs of the county’s residents. Randy Routon retired after serving 35 years as LifePath Systems’ only CEO.

Community Impact Newspaper sat down with Mahan to discuss her first eight months as CEO amid the pandemic.

Tell me about some of the roles you played before becoming CEO of LifePath Systems and how they have prepared you for your current role.

I started here back on Oct. 2, 1995—so I just had my 25-year anniversary. I came here straight out of graduate school. I got my master’s in counseling and came here to just start seeing people. I started as a caseworker once I got licensed, and that kind of changed my role a little bit. I started doing more therapy versus skills training and service coordination. Around 1999, I think, is when I stepped into more supervisory roles. I was over one of our outpatient clinics. I just kind of worked my way up through different program administrative roles until, in 2010, I became the director for all of behavioral health. I was the behavioral health director from 2010 until 2018, and that really gave me most of my experience, running that whole division. Behavioral health has so many different contracts—a lot of them are with [Texas] State Health and Human Services, and they all have different rules on how you can use the money and how many clients you have to serve and what kind of performance expectations are required by the state, as far as showing improvements or keeping people out of the hospital. And so, running that gave me lots of experience, and we created the role of chief operating officer. I stepped into that in 2018. That’s where I got experience for managing our other two divisions, the early childhood intervention and intellectual and developmental disabilities, and learning more about their contracts. I learned a lot about that and financing problems. Mental health has received some additional funds over the years, but [intellectual or developmental disability] really hasn’t; it’s a very cash-strapped division. I learned a lot about the needs there and how to advocate. Our CEO at the time, Randy Routon—he was our only CEO for the entire time we’ve been in existence. He started inviting me along to different legislative advocacy things, [like] meeting with our delegation here in Collin County and building those relationships. When Randy got ready to retire late last year, I knew that position would be open. It just kind of felt natural that I apply for it. I always like a challenge. I say that now—I had no idea it would be this challenging and we’d have a pandemic. Thankfully, the board chose me. He retired Feb. 15, and I started Feb. 16 in this role.

You started as CEO just before the COVID-19 pandemic started taking its toll on Collin County. What has it been like for you to step into this role amid a pandemic?

It has been a challenge. I’m not going to lie. It’s been a challenge, and it’s been a constant learning process. To start here for a half a month—and then, when March hit, we started getting questions from staff about, “Have you heard of this thing happening in China?”; “Are we going to do anything different?” So we started talking about our infection control measures and how to use universal precautions. It was a gradual process of one challenge after another. When the whole term ‘essential worker’ started being mentioned in the news, I literally had to Google ‘essential worker’ because that term isn’t in our contracts. It’s not a term that was in our lives before all this. I Googled it, and literally the first thing came up was the U.S. Department of Homeland Security, and they just updated some of their documentation and they included that term and a definition of who that is. It just seemed like every day or at least several times a week, I was having to Google something or call some contacts and talk to other CEOs at other centers. Every day was a new learning curve because everything was so different. Nothing was normal. The federal legislature started pushing out some of the CARES Act and the [Paycheck Protection Program], and I constantly had to dive into each one of those new things. "What is that? What does it say? Who’s written opinions on it? And how does it affect us?" It feels like I’m either in graduate school or I’m taking a doctorate program. I’m just learning every day as much as I can so [I can] provide the leadership to our agency, as far as what we are going to do.

What does a typical day look like for you right now?

Well, I’ve been coming in every day. I never really stayed at home. I don’t have a lot of people in the office around me. I have my assistant, and she’s in a whole other room, so we’re pretty good at social distancing. My goal was to try to stay as normal as possible and to be present for when staff had questions and needed me and to be close to my management team, even though all of our meetings are pretty much on Zoom. It began with daily meetings, trying to troubleshoot everything, and now, we’ve switched to one to two meetings a week where we all touch base and talk about changes.

Can you speak to how important the mental health and developmental services LifePath Systems offers has been for Collin County residents during the pandemic?

That’s another thing that’s just gradually come on. We provide crisis services to the entire county. We have a crisis hotline that takes calls 24 hours a day and dispatches our mobile crisis outreach team. Of course, we had to adapt that team on whether or not they go out. We spend a lot of time at hospitals assessing people with mental health conditions or substance abuse to authorize placement into a certain level of care. And so, of course, that stopped because hospitals weren’t letting anybody in the door for a while. Watching the data as it trickled in, there’s a bit of a delay because everything screeched to a halt in March, and we saw numbers just dip because you could tell everybody was sheltering in place. We had a lot less crises, everything was pretty quiet other than answering staff problems and us scrambling to try to get our hands on PPE so that we could safely interact with people. And then, maybe mid-April into May is when things really started going up because you could tell people tried to isolate as much as possible, and if they were having mental health problems, they just handled it however they handled it. By May, things were starting to crack and not do so well. Since then, we’ve really seen an escalation of substance abuse issues. There’s been a lot of detox needed, and there’s been a lot of overdosing; whether that was accidental or intentional, it’s hard to know. We definitely saw an increase in overdoses—some deadly, some not; some were caught in time. So substance abuse has been probably, by far, the biggest struggle because I think that’s how people are coping,. That’s what they can get their hands on easily: alcohol or other types of substances. The other one is the isolation and the anxiety that’s exacerbating people’s depression or anxiety. If they have trauma or other anxiety issues, that’s really been increasing as well. Now, we’re concerned about schools, too. Kids are pretty resilient. They can get along for a week or two or a couple of months, but after a while, problems start to bubble up. We’re hearing more and more kids struggling. How do we reach them if they’re not in schools? A lot of kids are home alone trying to do online schooling, and parents are trying to figure out how to work, so there’s a lot of stress. At the very beginning, we did see some spikes and psychotic symptoms [and] paranoia because people with a history of having psychosis, schizophrenia or other psychotic disorders—there’s that ongoing issue of the end of the world. That lasted for a good several weeks until we could get them into telehealth and make sure they’re taking their [medication] and where they come in. It was interesting to see it move from the fear that you see with paranoia to that more prolonged anxiety, sleep problems, just feeling anxious all the time. And that’s not just for people that typically have mental health problems. That’s average people out in the community. We received a FEMA grant through the state to provide phone-based counseling and brief telehealth counseling for just average, everyday citizens. You don’t have to have a diagnosis, and you don’t have to pay anything. It’s all through FEMA funds.

What short-term and long-term goals do you have for LifePath?

I’m very passionate about the services that we provide. Our mission statement is that we provide behavioral health and intellectual disability services to individuals and families in our community. Everything that drives us is to help our community. We’re here because that’s what we are at heart: We’re all helpers. Whether you’re a doctor or a counselor or support staff, we want to help people, and we want to see them get better. We’re constantly hiring, either from just natural turnover—but also just the growth. Collin County is growing, and we have to keep up with the population. I meet with our new employees on their first day of employment and talk to them about what’s important to us. The overarching rule is that we provide services to people. We have to be there for people. So even if somebody comes in and they’re too paranoid to wear a mask, we have to figure out how we help them. That doesn't mean we ignore and we come close to them and potentially infect each other. That means: How do we help them the best way possible? Hopefully, as fast as possible, by us wearing masks and the face shields and everything we can to protect ourselves. But we don’t turn them away because somebody with psychosis isn’t going to get better if we make them go away. That’s really the things that I see us continuing to do, just making sure all of my employees understand that message and what our purpose is and then being able to communicate that to the community. We know we have to make sure people know we’re open. We’re here. You can walk in; you can call a telehealth; we can do a video; we can do a phone call. But there’s multiple ways to get your needs met.

How can the community be in touch with LifePath Systems?

The easiest way is to call our number. We’ve got multiple numbers. There’s no wrong number. We’ve got everything from the crisis hotline that we publicize, that’s answered 24 hours a day, to our standard office numbers. People just need to call us, and then, we can talk through the options. We’re doing our best to meet that need by using all of our protective equipment and social distancing. A third of our services are still face-to-face right now, a third are through televideo, and about another third are phone-based. We’ve tried to make it as easy as possible.