For decades, discussions of mental health were best kept behind closed doors. However, as the world has evolved, so has healthcare, including the treatment and conversations surrounding behavioral and mental health. And thanks to new approaches to care, as well as passionate work from leaders in this ever-growing field, the lives of patients are changing as the stigma surrounding mental health disorders rapidly decreases. 

Nicole Sharbono is the chief operating officer of SMA Healthcare, which has been at the forefront of behavioral and mental health services in Florida for more than 60 years. The organization provides a full range of care and comprehensive services for individuals needing mental health and/or substance abuse treatment in Flagler, Marion, Putnam, St. Johns and Volusia Counties.

“There’s a portion of our history where institutionalization was the way of life. The thought process was that anybody who was experiencing or displaying signs of mental illness should be locked up. They should all be put into a hospital of some sort – most likely not to get out at any point in time,” Sharbono said. “And then, of course, we move forward to deinstitutionalization where the thought process was the exact opposite. We want to keep everybody in the community, and very few people should go to a state institution.”

But Sharbono said that mental health experts have realized the need for a balanced and individualized approach, including a continuum of care for patients with mental health needs.

“You want to have outpatient – you want to have your traditional therapy that most people think of. You want to have medication management for people who need a little bit more than just therapy,” she said. “You also want some residential programs where a person could go and live in a program…One organization cannot do it all, but we try to make sure we offer as many options as we can and then partner with the other companies or organizations that offer the areas that we don’t.”

SMA Healthcare began as two organizations – ACT Corporation, which was a mental health organization, and Stewart-Marchman Center, which was a substance abuse organization. The two merged in 2008 to serve a greater population.

“Mental health and substance use issues are public health issues, just like diabetes or heart disease, and should be treated as such. That’s been a big part of our evolution as an organization, Sharbono said.

The next step in that evolution is primary care.

“Knowing that a lot of people who struggle with mental illness and substance use issues may not be taking care of themselves in a way that they’re getting primary care or preventative care, that is our biggest initiative moving forward is to start offering primary care in as many of our locations as possible, so we can create a truly integrated campus, a one-stop shop for the people that we treat,” Sharbono said. “Primary care and behavioral health didn’t usually coordinate all that well in the past. When we can offer that all in one campus, we can ensure that those services are really coordinated to meet the needs of the person that we’re serving.”

Sharbono has seen tremendous growth in her field in the 11 years she’s been at SMA. And she doesn’t see it slowing down anytime soon, including the need for more mergers and acquisitions.

“There’s a huge evolution in how SMA operates as a more regional provider, but that’s also true throughout the state with other providers as well,” she said. “There is this evolution in behavioral health where to survive as a provider, you have to continue growing.”