Mettle Health Stepping Up Clinical Education

Many patients fall through the cracks of the nation’s health care system, and hospice and palliative care providers can help to fill in some of those gaps, according to Sonya Dolan, director of operations at California-based Mettle Health.

Mettle Health took root in 2020 when hospice and palliative care physician BJ Miller co-founded the for-profit company with Dolan, an artist and hospice manager at the time. Miller serves as president and counselor at Mettle Health. Miller and Dolan launched the company using personal funds, as well as a loan from a social venture foundation.

They established Mettle to provide a unique model of patient and caregiver support — counseling by interdisciplinary palliative care clinicians. This includes one-on-one counseling sessions with staff, interdisciplinary team counseling sessions, group support and monthly family meetings, advance care planning services, end-of-life care assistance and research and resource coordination.


“We go beyond the norm of palliative, hospice or caregiving support programs, so we don’t really have a box to define and label ourselves,” Dolan told Hospice News. “We support the patient, the family, caregivers and providers with our services and go beyond to link the human, philosophical aspects of how we interact with one another during times of serious and terminal illness and grief. We try to fill a lot of buckets. The closest we’ve come to defining it is a ‘philosophy of care.’”

Mettle Health is in the early stages of developing a series of online curricula for patients, families, caregivers, clinicians and other health providers, Dolan indicated. The goal is to connect more individuals with mental and psychosocial support related to serious illness, death and bereavement.

Each session in the provider curriculum will integrate different aspects of communication with patients and families and ways to help them navigate the uncertainties around serious illness and end-of-life care.


“We’re hoping these help coach clinicians on how they can hold those difficult conversations with patients and families and how their own life experiences can help them keep from losing themselves in the medical care space,” Dolan said. “It’s finding those universal truths and bringing your humanity to provide better care and help people navigate grief, loss and the end of life.”

Sonya Dolan RoboToaster, SmugMug
Sonya Dolan at the ELEVATE Conference. (Hospice News photo.)

To date, Mettle Health’s services have been offered virtually, but the company is now convening an in-person event in Nevada City, California, designed to bring hospice and palliative care clinicians together with patients and families to discuss ways to cope with serious and terminal illness.

“The core elements of our services help to fill huge, yawning gaps of need for people who might feel like they’re flailing in the caregiver space without help. There’s a lot of people out there who feel alone in that journey and have a variety of needs you don’t necessarily find in today’s health care system,” Dolan said. “We’re rooted in four core elements in our service offerings: support, witnessing and listening, expectation management and guidance. We’re stretching that out to include health care providers, clinicians and other professionals feeling burnt out in the serious and terminal illness space.”

Among its services, Mettle Health has seen demand grow for advance care planning, bereavement, caregiving support and assistance with navigating the health care system, according to Dolan.

“There isn’t much in the way of caregiving support organizations out there offering these services, so demand is high for support from someone who will listen and offer an educated ear on what people can do and suggestions for help,” Dolan said. “There’s serious power in the witnessing of what people are going through.”

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