Shortcomings of Evidence-Based Practice in Community Health

The bullying at the table overseen by the county’s new director escalated.

At the center of a table attack, I was told my actions weren’t intelligent. I was likened to Stuart Smalley. On another occasion, I was ambushed with several domain leaders present and accused of influencing and enabling “psychotic” clients to be against medication.

When I explained that I myself believe in and take medication, a worker from another domain who supported me was written up for not being a team player. I experienced no sense of an apology. I was accused of being paranoid by leadership when I complained. Shortly thereafter, I was vanquished from the meetings.

Meanwhile, back on the company’s ranch, the top administrator was out on disability. I hoped that the fact that our domain’s productivity numbers were steadily growing with me as the temporary leader, and that our specific company boss was replaced with someone who seemed to respect me might mean job security.

I was not looking for control of the program. I was fine with being number two. I was interested in being in a position to advocate for better wages for the workers. From my perspective, this was key to promoting quality services making a permanent stay in the county.

After two years, I got word that at the call of the county’s program director, I be demoted and put in charge of the charts.

My powers were totally stripped. When a worker was sick, I was not allowed to release them. The person had to work until my rarely responded to emails gave me the approval.

Unanswered emails resulted in much suffering. Productivity sank. Simultaneously, I was micromanaged. Company people publicly sabotaged my credibility in front of the team.

It occurred to me letting productivity tank could justify my demotion. I was told that I was disorganized which is true, but never had been brought to me as a concern. All details of the job that I was responsible for were done on time. I worked 60-hour weeks.

I never realized that disorganized people who have a history of success conducting therapy were only gifted when it comes to taking care of charts.

I made a rapid exit to a part-time gig at my old place and opened up a private practice for Medi-Cal clients. My application to be a Medi-Cal provider mysteriously stalled at the county’s highest level for reason that did not make sense. I pinched pennies, worried about mortgage payments, and eventually got back to full time back in the community I love.

Looking Beyond My Own Scars

I learned a lot about community dysfunction caused by EBPs from this experience. I believe it’s possible that this kind of experience has happened before in history as streams of funding and innovation have come in.
Ultimately, the county closed this expensive collaborative program and the out-of-state company I worked for lost its contract.

It was true that the company I worked for had some pretty awesome training and that they have successfully expanded.

I continue to agree with much of what they have to convey about mental health. I wouldn’t even be so brazen as to conclude that they unilaterally discriminate against racial minorities.

Shortcomings of Evidence-Based Practice in Community Health

Clyde Dee

Clyde Dee is an anonymous MFT and author of "Fighting for Freedom in America: Memoir of a "Schizophrenia" and Mainstream Cultural Delusions. Clyde writes from different states at different times. His blog site can be viewed at


APA Reference
Dee, C. (2016). Shortcomings of Evidence-Based Practice in Community Health. Psych Central. Retrieved on February 22, 2020, from


Scientifically Reviewed
Last updated: 18 Jan 2016
Last reviewed: By John M. Grohol, Psy.D. on 18 Jan 2016
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