Through community mental health care, Asbury aims to make a difference

Apr. 20—Dr. Mindy Asbury's road to psychiatry was a long one.

She envisioned becoming a caregiver, and as a child, thought she'd be a veterinarian. By the time she was a teenager, that dream had changed to human medicine, but Asbury said she wasn't sure on a specialty.

Around that time, she saw firsthand how hard quality geriatric care was to come by in rural areas like where she grew up in the Appalachian area of Kentucky and West Virginia, as her aging grandmother struggled to find resources.

"My first passion, what I thought I wanted to do, was geriatric medicine to care for her," Asbury, 46, said. "And then over time, based on different experiences, different education, different opportunities, it just melded over time to eventually land me in psychiatry."

Asbury's motivation to expand health care for rural residents has driven her to New Hampshire, taking on first-of-their-kind mental health posts at both Monadnock Family Services and Cheshire Medical Center in Keene.

"I really wanted to go somewhere where community was a value," she said, "where my being there would hopefully make a big difference."

Asbury serves as the chief medical officer at Monadnock Family Services — the region's community mental health provider — and as chair of psychiatry at Cheshire Medical. She started at Monadnock Family Services in August, and then at the Dartmouth Health affiliate in October.

While the positions themselves aren't new, one person holding both is, with an aim of creating a bridge between the organizations to provide better and more efficient care for local residents.

"It's safe to say she will have an oversized impact on the mental health system in the county, and perhaps even in the state," said Phil Wyzik, CEO of Monadnock Family Services. "A person who comes to New Hampshire with this level of experience, education, background, value set and perspectives about rural community mental health is rare."

Asbury's education and experiences run the gamut, including a stint in the Armed Forces, a doctorate program, a foreign residency program and enrolling in medical school, twice.

In 2000, she earned a Bachelor of Science from Mercer University in Georgia with an emphasis in bio-analytical and physical chemistries. A few months before receiving her degree, she enlisted in the U.S. Navy Reserve, in a program specifically for Navy physicians, which she graduated from in July of that same year.

Asbury said she then attended medical school, but took a pause in her schooling to serve as a Navy officer on and off for five years. Once out, she opted to not go back to medical school, and instead enrolled at Marshall University in West Virginia to earn a doctorate degree.

While there, she learned of a months-long addiction sciences fellowship in Amsterdam. Asbury has a family history of alcohol use disorder, she said, and was interested in understanding where addiction comes from and how it works.

"So I went to the Netherlands and I learned how to truly treat addiction," she said. "I mean, no one can do it as well as the Dutch, right? It's the first country to legalize marijuana, they give out heroin to people who are addicted to heroin, and the outcomes are good."

That fellowship was a catalyst to the rest of Asbury's career, shifting her dissertation focus to studying how methamphetamine causes irreversible damage to the brain.

Soon after, she decided to reenter medical school amid her graduate studies to become a psychiatrist so that she could help people dealing with substance use disorders and other mental illnesses.

Asbury earned her doctorate degree in neuropharmacology and neurotoxicology and her Doctor of Medicine from Marshall University in 2012. She then completed her psychiatric residency at Duke University in 2019, specializing in people with serious and persistent mental illness, like schizophrenia.

Local work, impact

Asbury most recently worked as the medical director at the University of North Carolina's assertive community treatment team, which cares for the area's most vulnerable populations. She also served as the psychiatry residency site director at Duke University, as well as medical director of North Carolina's First Episode Psychosis Program, which aims to provide care to teens and young adults who have or are at risk of developing psychosis.

Now in the Monadnock Region, Asbury spends four days per week at Monadnock Family Services and one day at Cheshire Medical.

The Keene resident said her work overlaps quite a bit at both posts, specifically with program development and optimizing the organizations' operations to provide better care — and more of it.

One example of this is in the emergency department, according to Asbury. Hospitals nationwide are grappling with overcrowding, with an unprecedented number of people landing in the emergency room and not enough beds or staff to help them.

Asbury said she's working on ways to intervene earlier when someone is in need of psychiatric care, before they head to the hospital. Outpatient resources also need to be ramped up, she said, so that people who do end up in the emergency department can be discharged earlier.

"She has played an instrumental role in aligning care at the Doorway, in our Emergency Department, and our outpatient practices with the most current evidence-based practice in psychiatry," Dr. Gina O'Brien, chief medical officer at Cheshire Medical, said in an email.

On the other side, Asbury said Monadnock Family Services is working on evolving its emergency response services to divert people from the emergency department because "we know that's probably not the care they need."

"Let's figure out how to best take care of them in the community and then keep them from even needing to go," she said. "Let's let us be that first stop, and if it's emergent, we'll send you on. If it's not, let's take care of it here."

Monadnock Family Services now also houses the region's only buprenorphine clinic, an injectable long-acting treatment for people with opioid use disorder.

This program was previously offered at The Doorway, a referral hub for substance use treatment run through Cheshire Medical. But, with the addition of Asbury, the hospital felt it "made the best strategic sense from an operations standpoint" to transition the clinic to Monadnock Family Services, according to spokesman Matthew Barone.

Reopened in January at 40 Avon St. in Keene, the free clinic is available every other Tuesday afternoon to anyone in the region who may need it, regardless of if they are a client of Monadnock Family Services.

The clinic has about eight participants, Asbury said. Anyone interested can call Monadnock Family Services at 603-357-4400 or go to The Doorway for a referral.

Asbury's work has already been noted by city officials, with Mayor Jay Kahn recognizing her at a city council meeting last month.

Looking forward, Asbury said she is enamored by the support she's received in her new roles, both from the organizations and the community utilizing them.

"People are rallying behind MFS, people are rallying behind the hospital, people are here supporting the work that we do, and I've never seen anything like this ... ," she said. "The days that are terrible, just knowing and thinking we have that support, just makes it more bearable."

Funding for the Monadnock Region Health Reporting Lab comes from several sources, including The Sentinel and several local businesses and private donors. We continue to seek additional support. The newsroom maintains full editorial control over all content produced by the lab. Olivia Belanger can be reached at 352-1234, extension 1439, or obelanger@keenesentinel.com. Follow her on Twitter @OBelangerKS.

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