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Getting Help When Mental Health Is Urgent ... But Not Enough For The ER

Renee Bright / KUER

In the Hive Mind, KUER reporters take questions from our listeners and try to help find the answer. This week KUER spoke to a woman with a life or death question about mental health. 

Out of sensitivity to the caller’s privacy, only her first name is used.

Jessica didn’t know what to do. For years her brother has struggled with serious depression. About two years ago, he started considering suicide.

He asked Jessica for help and when she got to his house, she said, he was curled up on his couch, unable to take care of himself.  

The good news was her brother had insurance. He had options, she thought.

Credit Renee Bright / KUER

"I began by downloading which psychiatrists his insurance covered. And the list was long but I was able to identify a few doctors close by and called about setting up an appointment," she said. 

... for somebody who is experiencing really urgent mental health challenges, this is just not a practical process.

But the wait time was about six weeks. He needed help sooner. While her brother got medications from his doctor to get stable, Jessica tried to find him a long-term therapist.

She made an Excel sheet with all the options. She narrowed by PhD. She narrowed by location. Only a few had websites. 

Feeling pressure to help her brother, Jessica felt lost.

"I understand that the process for finding a therapist is really personalized and it takes some time and meeting with people but for somebody who is experiencing really urgent mental health challenges, this is just not a practical process," she said. 

Jessica was left with the question: How do you find a therapist?

According to Barry Rose, there is no right answer to that question. 

"It really is difficult," he said. 

Rose is the manager of the University Neuropsychiatric Institute or UNI. On a recent day at their office in downtown Salt Lake, a dozen employees took calls on different phone lines. There’s the crisis line and the warm line people can call for support. Crisis workers were also texting with clients on the SafeUT app. UNI is the only 24-hour phone resource in the state. Rose said their crisis line alone takes between 4,000 and 5,000 calls per month.

Credit Renee Bright / KUER

"I think one of the best options would be to call somebody like us. Call our crisis center. Call our crisis line and say ‘this is my situation, what would you recommend?’" Rose said. 

Amy Ross is a social worker with the UNI crisis line. She demonstrated how she would to respond to Jessica's situation during a recent call to the phone line. 

"When you say he’s not actively suicidal, he’s reporting suicidal thoughts but just to clarify, is he reporting any kind of plan, does he talk about any means?" Ross asked. 

Ross asked if he’s taking medications and where he lives. She offered advice on how to navigate insurance and about local mental health providers.

I get calls all the time from people who are like 'where do you think I should tell someone to go'

Mental health care is different from hospitals and other parts of our medical system. First, there’s a shortage of therapists in Utah. But it’s also organized differently. We don’t do annual check-ups for mental health, so it’s not as common to see therapists, they often have private practices outside of a hospital and unlike a doctor you might see for a broken leg, it’s important to find a therapist you have a personal connection to. Add the stigma about mental health and finding a therapist can be hard in even the best situations.

Kim Myers is the Suicide Prevention Coordinator at the Department of Human Services. She said one tried-and-true method is a recommendation from a friend.

"I get calls all the time from people who are like ‘where do you think I should tell someone to go?’ And honestly, I have a pretty short list of people I have direct experience with that I feel comfortable and confident referring people to," Myers said. 

Otherwise, she has two suggestions: The Utah chapter of the National Alliance on Mental Illness and Utah Support Advocates for Recovery Awareness, which focuses on addiction.

People shouldn't have to go to like a million different doors. We should just have a really clearly marked front door.

According to Myers, when it comes to mental health people often talk about a ‘no wrong door’ approach. It’s the idea that teachers, preachers, doctors and counselors should all know the basics about mental health and be able to make referrals. She says, if it’s done right, it can work. But, it can also create a confusing number of options for people like Jessica.

"Well maybe we don’t need a ‘no wrong door’. People shouldn’t have to go to like a million different doors. We should just have a really clearly marked front door," Myers said. 

Unfortunately, there isn’t an easy solution to find a therapist in situations like Jessica's that are urgent, but not quite crises. Our mental health care system is fragmented in ways that our physical health system isn’t.

"Okay, well at least it’s not just me then. Because I thought, surely there’s some more organized way but if that’s just the reality then, at least it’s not just me," she said. 

Jessica says her brother is basically back in the same situation as before. He’s mostly better, he doesn’t have a therapist and they’re hoping things don’t get worse. Because if it does, getting help will take time.

If you or a loved one are experiencing a mental health crisis, you can call: 

National Suicide Prevention Lifeline: 800-273-8255

University Neuropsychiatric Institute: 801-587-3000

National Alliance on Mental Illness: 801-323-9900

Utah Support Advocates for Recovery Awareness: 385-210-0320 


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