Sandra Wilkniss, PhD

Every state has some kind of health care delivery system but every governor is not a health care expert. That’s why the National Governor’s Association has a Center for Best Practices Health Division. Psychologist Sandra Wilkniss, PhD, is program director for the division’s behavioral health and social determinants – a formidable title for a job that has become even more important as America’s health care system is evolving. A major challenge for governors is that behavioral health has long been addressed separately from the remainder of the health care system, Wilkniss says. “The trend toward person-centered, team-based care has moved many states toward models of integrated care,” she says. “As a psychologist who has spent time in several health care settings – academic medical center, state hospitals and community psychiatric rehabilitation organizations – I am able to provide on-the-ground perspective on challenges governors face in this endeavor.”

In addition, she says, her research background is essential to evaluating the evidence basis for health care practice and policy decisions. “My time is spent providing various forms of technical assistance to governors’ policy advisors and their teams, writing grants and papers, and organizing and executing meetings of multiple states around specific policy topics,” she says.

In 2011, Wilkniss was an APA congressional fellow, working in the office of Sen. Jeff Bingaman, D-N.M. She chose Bingaman’s office because of the senator’s seniority, knowledgeable staff and his assignment on the committees that cover health-care issues. Over the year, she worked on health-care reform implementation (including mental health issues), health issues along the U.S.-Mexico border, the Supplemental Nutrition Assistance Program, and mental health and Medicaid.

The fellowship was fantastic, she says, giving her "a true appreciation for what is meant by policy being shaped by 'five Ps'—policy, politics, procedure, personalities and press." She also appreciated that colleagues welcomed her ability to contribute. "My training and experience as a psychologist were respected and welcome in substantive conversations about legislation, which intersected with my areas of expertise," she says.

Before the fellowship, Wilkniss – who holds a PhD from the University of Virginia – served four years as director of the Thresholds Institute, the research and training arm of Thresholds, a Chicago-based community psychosocial rehabilitation organization. There, she led the research and training efforts around adopting, implementing and refining evidence-based practices for people with serious mental illness. “I learned a tremendous amount about the significant needs of Thresholds’ members -- adolescents and adults with serious mental illness -- and the major policy, workforce and financing challenges that significantly limited their access to the best quality care and opportunities to improve their lives,” she says.

She describes her career path as “less deliberate than fortuitous.” “I had always planned to be an academically oriented scientist-practitioner,” she says. Her original interest was in neuroscience and artificial intelligence but after completing her undergraduate degree, she worked as a research assistant at the National Institute of Mental Health, conducting experiments on attention in people with schizophrenia both on and off medication. “I was hooked, went to grad school in clinical psychology and never looked back,” she says.

Another career-shaping factor was “a series of encounters over the course of my career with individuals with serious mental illness shaped my path – the unique combinations of resilience and challenges each individual I encountered managed daily, my outrage at the lack of opportunity each had to improve his/her life, and the lack of access to the best treatment and supports,” she says. “The rest was a lot of luck and a little thinking outside the box.”