A champion for mental health and substance abuse education and treatment in Utah –Patrick Fleming—retired in December as Salt Lake County’s director of the Division of Behavioral Health. Pat is one of the master designers of a collaborative health care model that to this day sets Salt Lake County and Utah apart in the nation for its effective delivery of behavioral health services to our residents.

Although Pat began his career here in the private, nonprofit sector—as the director of a domestic violence program—his true talent was revealed when he moved into county and state government roles. In the 1990s, while working in behavioral health for the Utah County Commission, Pat noticed that 40 people a day were making the drive to Salt Lake in order to visit the Project Reality methadone clinic. Heroin addiction in Utah County wasn’t openly acknowledged. But Pat’s conversation with a young couple—she, six months pregnant—led him to Commissioner Malcolm Beck’s office with a passionate request to start a methadone clinic in his county. It operates to this day in the Utah County Administration building.

Pat also worked in the administrations of several Utah governors.  He says one of his mentors was Leon PoVey, who brought him on as the state’s substance abuse division business manger. From PoVey, Pat learned that “you’re never going to be the smartest guy in the room but you can work to be the best.” At the state, Pat absorbed the complexities of Medicaid funding, through his job with the Office of Family Support, within the Utah Department of Social Services. Pat observed that many of the families receiving welfare and food stamps either had substance abuse problems, mental health issues or both. He had found his calling as an advocate for programs and funding to offer treatment.

In 1994, one of Pat’s research efforts—funded by a small federal grant—at the old Salt Lake County jail—alerted him to street intelligence from the inmates, that a terrible, new addiction problem had arrived in the state —methamphetamine. While men normally abuse drugs at three times the rate of women, meth devastatingly reversed that ratio.  Pat said the face of meth addiction became a young, single mother with two small children.  Carrying a cardboard cutout of a silhouette of a woman and her kids with him to legislative meetings, Pat successfully fought for the creation of a special task force. He argued that you could jail the mother, place her children in foster care and pay $100,000 or offer treatment at a cost of $17,000. The result was an agreement that led to customized treatment programs for female meth addicts. 

Pat notes that Utah has always been a place where compassion has won out over punitive sentences.  Too many Utah families learned from tragic experience that mental illnesses and substance abuse do not discriminate by economic status, education, or religion.  Anyone can fall victim to the disease. He speaks movingly about the many brave, outspoken Utah advocates he has met that helped shine a light on this very personal problem and helped erase the stigma attached to it.

Pat says he’ll continue to be a volunteer lobbyist on behalf of NAMI-Utah and USARA.  He’s proud that, while not personally in recovery, he has the trust of the men and women in that circumstance who have accepted him as one of them. He’ll also provide some consulting to counties who are interested in learning more about the Utah collaborative model that enables local government to deliver better, more wide-reaching service in an efficient and cost-effective manner.

Pat has incorporated the advice he received from his early mentor—Leon PoVey—to “find something you can really commit to.” Without question, his commitment has improved people’s health, helped preserve families, and saved lives.