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In Memoriam: Thomas A. Kirk, Jr., PhD

April 23, 2020

Thomas A. Kirk, Jr., PhD, former Commissioner of the Connecticut Department of Mental Health & Addiction Services and Adjunct Professor of Psychiatry whose leadership transformed Connecticut’s mental health system and strengthened Yale’s role within in, died on April 9. He was 78.

Kirk led the Connecticut Department of Mental Health and Addiction Services (DMHAS) from 1999 to 2009, a decade of service marked by substantial and sustained system transformation efforts, as “Captain” Kirk steered the DMHAS starship toward a fuller and fuller realization of what he was the first to envision as a “recovery-oriented system of care.”

During this time, he built upon existing structures and relationships to forge a close, collaborative, and mutually beneficial partnership between DMHAS, the Yale Department of Psychiatry, and the Connecticut Mental Health Center, a lively hub for clinical care, research, and education and the core of the State-Yale mental health partnership. A model of diplomacy and thoughtful deliberation, Kirk understood the tensions and advantages inherent in state/university collaborations and preferred always to focus on the well-being of patients within the system of care. With his visionary leadership, he enhanced dramatically Yale’s understanding of community mental health and made the State-Yale collaboration vibrant and productive.

Kirk could see the “big picture,” the entire system of care delivery. When he began, the Connecticut mental health system — like all state mental health services at the time — focused almost exclusively on end-stage, serious behavioral illness. He was the first state commissioner in the nation to appreciate the system-wide ramifications of the Recovery Movement for changing the nature of behavioral health care. Not content with simply adding new components to an old system, in 2002 he made Connecticut the first state to have a Commissioner’s Policy that inaugurated a top to bottom refashioning of the behavioral health system to be person-centered and culturally responsive — a model that would soon be adopted and disseminated by the federal Substance Abuse and Mental Health Services Administration (SAMHSA).

Deeply committed to ensuring a high quality of care, Kirk introduced practice management strategies for improving retention in and outcomes of care, grounding DMHAS policy and practice in data and evidence. Throughout these efforts, he appreciated the service and research missions of the Yale Department of Psychiatry, supporting and drawing upon the expertise and innovation of faculty. He was constantly asking about the newest findings and treatment breakthroughs so that he could be sure to offer the citizens of the Connecticut the best and most effective care possible.

Under Kirk’s leadership and direction, and in close collaboration with Department of Psychiatry faculty members, Connecticut received over $100 million in SAMHSA grants to improve the care provided to persons with co-occurring mental health and substance use disorders, those from underserved, marginalized populations, and persons with histories of trauma. In partnership with the leadership of the Connecticut Mental Health Center, Kirk worked closely with Departmental faculty researchers in the Division of Substance Abuse toward the integration of mental health and addiction services, helped to expand the Law and Psychiatry Division, provided the core infrastructure funding to create the Yale Program for Recovery and Community Health, supported early intervention in psychotic illness, and championed the expansion of supported housing.

“I was deeply impressed by his nuanced views, his deep insights into the political context, his determination, and his tireless efforts to help those with mental illness,” said John H. Krystal, MD, Chair of the Yale Department of Psychiatry. In recognition of Kirk’s support for the academic mission of Connecticut Mental Health Center and his role as DMHAS Commissioner, the Department awarded him the first Yale Mental Health Research Advocacy Award in 2006.

“Dr. Kirk was a true pioneer in the field of behavioral health,” said Miriam E. Delphin-Rittmon, PhD, Commissioner of DMHAS who worked with Kirk early in her career. “He was driven by a desire to enhance every system of care for which he had responsibility … I know I speak for the entire behavioral health community in Connecticut when I say thank you Tom.”

Selby Jacobs, MD, Professor Emeritus of Psychiatry and Public Health who served as director of Connecticut Mental Health Center throughout Kirk’s tenure, reflected, “While being a system visionary, he was also a deeply committed clinician who understood and was able to relate to recipients of care and their families. He could do it all, from the micro-clinical to the macro-system, a combination of skills that is rare..

Above all, Jacobs continued, “Tom was a kind, caring, compassionate, down-to-earth, gentle person. He was a good friend. We miss him deeply. We will not forget him.”

Submitted by Christopher Gardner on April 23, 2020