Dr. Anidolee Melville-Chester has served as the Division Director of Behavioral Health and Wellness with the Metro Public Health Department for about 15 months. She is passionate about building a community wide, collaborative system of care that looks at all aspects of health and well-being centered on the needs of Davidson County residents.
Melville-Chester holds a PhD and a master’s degree in public administration. Her background is in program management, program administration, clinical counseling, teaching and supervision. She is a strong advocate for underserved, under-insured populations.
“I started out doing this work as a nurse,” Melville-Chester said. “I’ve done it as an advocate. I’ve done it as an educator. I’ve done it with Children’s Services, with United Way, with Corrections, and now with Metro Public Health.”
She committed to moving her work forward by being intentional about creating a system of care based on data and analysis that helps ensure funding and resources are being allocated to meet the need.
You have been the Division Director of Behavioral Health and Wellness with the Metro Public Health Department for a little over a year. What does your job entail?
Behavioral Health and Wellness is just what it says. It really looks at what drives individuals’ behavior. How do we get them from where they are to a place of wellness? When you think of an individual, most people approach individuals as “they’re broken, they need fixing.” But when you look from a clinical place at an individual, you look at the fact that they’re not in concert with their health. So, the goal is to get individuals back to a place of wellness where they’re functioning well — physically, financially, academically, environmentally, socially and personally. We look at the individual in a holistic way.
My job entails looking at programs that address the needs of the community whether it’s violence prevention, suicide prevention, opiate use and misuse, lack of clinical services, the needs of the unhoused, gaps in service to the youth and young adult population, creating safety for all Nashvillians and residents of Davidson County — just examining what all that looks like. Then the question is, how do we create a system of care in Nashville-Davidson County that strengthens individuals from where they are to where they need to be so that we’re a healthier community because we have healthier individuals.
Who are the main partners you work with in Davidson County and what are your top priorities for the next five years?
We have a plethora of partners covering health, mental health, schools, universities, the Mayor’s Office, hospitals, police, etc. It is a cross section of partners, all the individuals who work on addressing the wellbeing of individuals residing in Nashville-Davidson County.
One of our major priorities is looking at our youth serving population and the impact of suicide, violence and substance use on that population. That’s huge. The other priority is making sure we have linguistically and culturally appropriate and culturally relevant services for the community.
The next thing is making sure that we have behavioral health services and clinical health services available to the community. Right now, the waiting time for individuals to access a clinician is very lengthy. Metro Public Health is bridging that gap by having clinical and counseling services available in all of our clinics. We will be online with that in late July [or] early August. We’re going to have services for all of our communities, including those who speak languages other than English. The beauty of this is that there are no criteria to access services beyond the fact that you need someone to talk to.
A big part of our messages is, “Hope is available to everyone who needs it.” We want to make sure the community knows we hear you. We hear you when you say there’s a lack of services in the community, and we want to respond to those needs. [For example], we know a big part of that is not having available beds in Davidson County for individuals who either overdose or individuals who need treatment. Our priority is to focus on creating more beds for individuals to have detox and treatment when they’re involved with a substance.
The priority is a healthier Nashville and Davidson County over the next five years. A community where violence is decreased, a community where suicide is decreased, a community where we can see some decrease in opioid use and emerging drug use in Nashville-Davidson County.
We realize at Metro Public Health that we cannot do this alone. So, we look to our partners in violence prevention. We currently have community partners that have been working diligently to assist us with this. We have the Urban League. We have the Community Foundation of Middle Tennessee. We have The Contributor. We have Raphah and Rocketown and Creative Girls Rock, individuals in the Somali community, and Neighborhood Health, just to name a few.
We’ll also be putting together a community board of 18-to-24-year-olds to inform the work. One of our priorities is, “Nothing for you without you.” We want to hear the voice of those individuals that can tell us, “Listen, here is what’s happening, here is how to go about that.” To that end, we are working diligently to ensure that we have an advisory board of that age group to advise us on our community violence prevention and intervention work. We want this age group to know that if they’re interested in working with Metro Public Health to help us with this work, we welcome them to contact us.
(To do so, call the Metro Public Health Department’s main number at 615-340-5616 and ask for the Behavioral Health and Wellness Division).
As part of your job, you are also overseeing daily operations of Opioid Prevention Services. Are there gaps you would like to see filled in the prevention space?
The prevention space I believe is going to look a little different than what may have been seen in the past. Looking at the research, looking at the data, and looking at creative voices through a study that was conducted for us over a two-year period, [we know] that having clinical services and resource linkages is key to opioid prevention.
What prevention services look like right now is outreach and education leading to case management services linking to counseling and therapeutic services. We will have that available for our Spanish-speaking community, our English-speaking community, our Arabic-speaking communities and many others. I think doing that is going to strengthen the efforts of our prevention.
We’re the recipient of a three-year grant from the state and [work] with the state to pilot and implement an opioid care system over the next three years. We’ll be looking at research, data, bed management services, and medication assisted treatment. We’ll also be focusing on our unhoused population, individuals who are incarcerated and coming out of that system, and [explore] what it is going to take to engage people so that we are decreasing repetitive use. We’re in partnership with our hospitals, with our police, with our treatment serving communities such as the Samaritan Recovery Community, Mental Health Co-op, and others that we will engage to help us in this work.
It’s about prevention, intervention, treatment, and stabilization of housing, moving individuals from unhoused to respite care, to transitional housing into permanent housing. That is key to ensuring the well-being of individuals. And so, we’ll be working with the unhoused population, working with our homelessness coalition and our division there to ensure that we’re working together to strengthen services and to strengthen our collaboration and to strengthen care in Nashville-Davidson County.
How much was the three-year grant from the state?
About $2.1 million per year over three years.
Prior to joining Metro, you worked for several years as the Deputy Director of Clinical Services of the Tennessee Department of Corrections. In your view, what opportunities do governments have in improving healthcare in correctional settings?
The Department of Corrections worked diligently to create both physical and behavioral healthcare services in our prisons across the state. Individuals — we call them inmate patients — that are in the system are able to access medical care for the needs that they have within the prison system. Now, when you operate medical care from the prison system, there are always adjustments that you need to make beyond when you’re out in the free world.
I believe [the] quality of care from the Department of Corrections has improved. I saw those improvements when I was there as a staff person. Attention is being paid to individuals, whether they’re diabetic or have cardiac issues. The Department of Corrections has also created a dialysis center where individuals are able to [receive dialysis] right there in the clinical setting. That’s a big improvement in healthcare. Their partnership with Nashville General Hospital and their partnership with major hospitals across the state helps to make sure that if individuals’ needs cannot be met within the prison system, they are being met in clinical settings across the state. There is always improvement that can be made with healthcare — whether in a correctional setting or in a public health setting. But I do believe that with the resources that the Department of Corrections has, they’re doing everything to strengthen those healthcare services in the settings that they have.
At the Metro Public Health Department, we oversee behavioral health and medical services in the jail system here in Nashville-Davidson County. We’re always looking at those services and have cultivated a strong partnership with the Sheriff’s Office to ensure that quality services are being rendered to inmate patients and that we are following the standards for health and behavior health services in the jails [as outlined by the] National Commission on Correctional Healthcare.
So, both entities try their very best to work on ensuring that the standards that are set nationally for prisons and jails are being maintained as it relates to healthcare services. Do we get it right all the time? No. But what I admire and what I’ve seen working is that they’re doing continuous quality improvement to ensure that those services are rendered in the best interest of the inmate patient.
How much of a connection to homelessness and housing insecurity do you see in your daily work?
As an individual, as a resident, all you have to do is drive through Nashville and you can see homelessness. But I think working with The Contributor, working with our individuals that are addressing homelessness, working with the Mission, doing our outreach and education in the community, all that gives us the connection to begin to address the needs of the unhoused population.
We are increasing our outreach and education to the unhoused population. One of the things we have to address from a public health and a citizen’s perspective is to have Naloxone, [a medication used to rapidly reverse opioid overdose], available for the unhoused population so that if they get into trouble, they’re at least able to have access to that.
When I started here in Behavioral Health and Wellness 15 months ago, there was just a staff of seven. Currently, we have a staff of 15, and we will grow to a staff of almost 40 by the end of August and September. We have really taken a look at what the needs in Nashville-Davidson County are, we have allocated funding to support services in the community, and we are making sure there is access for those who need it.
Strengthening our community partnerships, increasing our resources, and increasing outreach and education services, is going to get us where we need to go in the next three to five years. I will say that we have support from our Mayor, who is passionate about this work. Also, the Mayor’s Office is passionate about the work of safety, passionate about the work of mental health services, passionate about the work of the unhoused population and services to the youth serving population. And our leadership here in Metro Public Health has the same passion, our Board has the same passion, and that’s amplified with the passion that you guys have at The Contributor – so when we have all of these entities working together and we’re not working in silos, I think we have the best chance of leveraging our resources and stabilizing our community.