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When a group of Huntington, West Virginia, community organizations collaborated in 2018 to create a substance use treatment center, they quickly determined that they wanted the center to offer not just drug and alcohol treatment and counseling. They also wanted the center to offer clients spiritual care.

Rather than have the PROACT center hire a chaplain on its own, the group determined the best source of chaplain expertise was St. Mary's Medical Center, one of the founding organizations. Since St. Mary's pastoral care department did not have the capacity to spare a chaplain to work full time at PROACT, the hospital and its partners in PROACT came up with a solution: St. Mary's added a chaplain for PROACT to its own staff of chaplains, and PROACT contracts with St. Mary's for the chaplain's time.

The arrangement was so successful that a second organization requested the same model. St. Mary's has been contracting out chaplain services to the Cabell–Huntington Health Department of West Virginia since 2022. St. Mary's is open to engaging with other organizations as well.

Rev. Greg Creasy, director of the department of spiritual care and mission at Huntington's St. Mary's, says PROACT and the health department "reached out to us because they know we have strong chaplaincy services, and they said, 'Why would we try to do this ourselves, when St. Mary's is already doing this locally?'"

He says spiritual care "is an investment they are making."

Opioid crisis
The pastoral care department of the 393-bed St. Mary's has six full-time chaplains, including the chaplain assigned full-time to PROACT and one who splits time between the health department and St. Mary's. St. Mary's chaplain team is ecumenical — one chaplain is a priest, one a Presbyterian minister, one a Quaker, one a Mennonite, one a Baptist and one from the Church of God.

Rev. Creasy, who oversees the department, was part of the team that represented St. Mary's when the hospital joined with numerous partner organizations to create PROACT, which stands for Provider Response Organization for Addiction Care & Treatment.

The group formed — and help to fund — the nonprofit PROACT because of their concerns about the substance abuse epidemic that has been crippling West Virginia, and Cabell and Wayne counties in particular. West Virginia has had the highest rate of opioid-related overdose deaths in the country every year since about 2015, according to the Centers for Disease Control and Prevention.

Fully embedded
Established to bridge a gap in services for people using opioids and other substances, PROACT provides outpatient medical and mental health assessment, medicine-assisted treatment and group and individual addiction therapy as well as help finding jobs.

Rev. Rodney Adkins is the chaplain who has staffed PROACT since 2018. While he is part of the St. Mary's pastoral care department and attends meetings and other activities at that hospital, his office is at PROACT, and that is where he spends most of his time. "I'm very much a part of the culture here at PROACT," he says. "I'm fully embedded."

Rev. Adkins tries to meet every one of the hundreds of patients who seek treatment at PROACT each week to make them aware of the spiritual services he can provide. PROACT staff will refer patients who express a desire for spiritual services to him. And he attends group therapy sessions at the center and offers his services to those group members.

He says he spends lots of time "wandering the halls" of the center on the lookout for new faces. He works on relationship-building in hopes that clients will feel comfortable accessing spiritual care from him.

Rev. Adkins offers individualized spiritual care. He talks with his clients about their spiritual history, where they stand spiritually and where they want to head. He can connect them with local religious leaders and spiritual resources.

He says research shows that the type of spiritual care he is offering his clients leads to better outcomes for substance use therapy.

Employee retention
Rev. Creasy said while the chaplain arrangement serves mainly clients at PROACT, it is a different situation for the health department contract.

That contract came about because health department leaders had recognized that amid the COVID pandemic, health department staff were under extreme strain. Additionally, some staffers suffered from their own health issues, which compounded their stress. Leadership wanted to offer employees access to spiritual care in addition to the assistance already available, such as counseling.

The health department contracted to have a St. Mary's chaplain on-site on an ongoing, part-time basis. Rev. Creasy says health department leadership has been very pleased with the results.

"It's about resiliency and accessing the spiritual resources needed to be a healthy employee. It's a total look at the individual as a whole person," explains Rev. Creasy. "And, when we offer that, we see there's better employee retention."

He says employees also feel more engaged with their workplace when their spiritual needs are met.

International recruits
Rev. Creasy is unaware of any other hospital in his region contracting out its spiritual care services as St. Mary's is doing. He says St. Mary's provides the services at cost. "We're not trying to make money — this is part of our ministry to the community," Rev. Creasy says. "We care about and understand the importance of whole-person care — it's the strength of chaplaincy."

He says that despite a nationwide shortage of chaplains, St. Mary's has been able to fully staff its chaplain positions plus hire these additional chaplains to contract out to other organizations. He says the department has been able to find well-matched applicants on an ongoing basis in large part because of its in-house clinical pastoral education program. His department has hired numerous chaplains who served at St. Mary's through that program.

He notes that St. Mary's has had much success in recent years recruiting for its clinical pastoral education residents from overseas. Several such recruits have come from Tanzania, one from South Africa and one is a Pallottine Missionary Sister from Poland. Pallottine is the congregation that founded St. Mary's.

Present to struggling people
Referring to the contracted chaplaincy work, Rev. Creasy says it takes intentionality for organizations to see to the spiritual care of their clients and employees. "It's about being present to those who are struggling," he adds.

St. Mary's pastoral care team is so convinced of the value of their services that they have been offering their expertise to others to give back to the community, says Rev. Creasy. For instance, they helped the local police department develop a chaplaincy program.

He says St. Mary's has been "thrilled by the opportunities" that have been arising to extend spiritual care more into the community. He says "the chaplains have made a huge impact in the lives of the people they serve."