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O'Malley and the others are angry about the way Mandel ran her operations. No one, they say, gets into social work without an understanding that the needs of the patients come first. Because of Mandel's strong religious convictions, as well as her open-minded approach to healing, they hired on with her confident that they were destined to do good work.
That, they say, was not the case.
"My goal is simply to take her license," says Ray. "I want her to be non-employable, just like her clients. I want her to feel for one second what it is to be helpless and dependent on another human being."
JoAnne Mandel's professional history and promotional writings suggest that she's an extremely resourceful woman.
The daughter of a linotype operator and a housewife, Mandel was born and raised Mary Jo Romey in a small town in rural northwest Iowa. According to her first husband, Eric Orzeck, Mandel struggled mightily against the mundane circumstances of her life in the Midwest.
"I think her strength is the fact that she is coming from a background where she has made herself the most educated person in her family," says Orzeck. "She was determined to get out of that small-town community and into a bigger city, where she could actually function."
Determined might be an understatement. From 1969 -- a year after she married Orzeck -- until the early 1990s, Mandel's life was an almost obsessive exercise in self-improvement. The first of her three degrees was a bachelor of science in nursing from the University of Iowa in 1972. Though caring for a one-year-old daughter, she immediately began a master's program in Italian Renaissance art history.
Mandel continued those studies at the University of Virginia while working as a nurse in the intensive care unit at the university's teaching hospital. Mandel and Orzeck divorced in 1973, though within a few years they were both living in Houston. Mandel married again, and by the time she divorced a second time in late 1982, the former Mary Jo Romey was lost and confused.
At her InnerWisdom Web site, Mandel describes the early '80s as "the lowest point in my life." Grasping for answers, she submerged herself in holistic and New Age studies while holding down full-time nursing jobs at M.D. Anderson and Texas Woman's Hospital. She took courses in nutrition, vitamin therapy, stress management and Reiki, an Oriental form of therapeutic touch. In 1983, she earned a "master's degree" at Houston's Esoteric Philosophy Center, where she later taught human physiology and herb therapy.
Meanwhile, Mandel began developing the Total Living Concepts Family Center, which would offer a wide range of progressive mental-health treatment to families. In a business plan she prepared, Mandel saw a world gone mad with divorce, incest, domestic violence and the spiritual corruption of children. Noting the "rich market" of the Houston area, where most working families carried some type of health insurance, she proposed to make a combination of traditional psychoanalysis and holistic care available at a single facility.
With its special emphasis on children -- "our culture's greatest natural resource" -- the family center concept seemed to address the very alienation and "overwhelming feeling of insufficiency" Mandel says she experienced as a child. Coincidentally, the program was also designed to produce a new generation of mental-health services consumers.
"The future of the world depends on our children's conceptions of themselves and all their choices depend on their inner view," Mandel wrote in the business plan. "What is happening to our children today? They are being neglected, beaten, abused and shamed. Their inner identity is being destroyed."
In 1982, Mandel earned a degree in psychology from Houston International University -- where she later served as chairman of the board. She received her master's degree in social work from the University of Houston three years later. By then she had legally changed her name to JoAnne Dreyfus Mandel. According to Orzeck, who has maintained a relatively close relationship with Mandel over the years, the change "symbolically freed her of the past."
"I believe it was so she could become that person of her own, without my name or anyone else's attached to it," Orzeck says. "She could have her own life under a name that she felt comfortable with, that was her view of herself and of her own worth."
Mandel opened the River Oaks Health Alliance in 1992, and from the outset, ROHA was a manifestation of the miracle that had transformed Mary Jo Romey into JoAnne Mandel. The clinic embodied an almost shamanic philosophy, with its core belief in the powers of God, the mind and age-old medical principles. But ROHA had a more earthly goal, as well: to bring alternative healing into the modern world of managed health care.
Michael Yeager, a therapist who specializes in grief counseling, was one of the first practitioners to rent office space from Mandel. He says she was not only "ahead of the field" in addiction treatment, but also by challenging mainstream medicine's iron grip on the American health-care system.
"She certainly opened me up to treating addiction in a very different way," Yeager says. "Everything was done on a physiological and spiritual basis that helps the addict move away from their addictive behavior into healthy behavior. I certainly saw some good results. But JoAnne was using concepts, things that were innovative and creative, that managed health care certainly doesn't acknowledge because physicians aren't involved and physicians own managed health care."