October 28, 2020

Mental health urgent cares provide relief for patients and hospitals

SSM Health Behavioral Health Urgent Care opened on Aug. 24, offering patients specialized treatment for mental health crises.

Mental health crises are traditionally and increasingly treated in hospital emergency rooms (ER), but for patients, this usually means extended waits and little access to follow-up treatments. On Aug. 24, the SSM Health Behavioral Health Urgent Care opened its doors to the adult public and ushered in a new approach to community mental health.

“We provide a service for patients who need emergent and urgent care where they can receive care from professionals trained in behavioral health and substance abuse disorders,” said Michelle Schafer, SSM Vice President for Behavioral Health. “They don’t have to go to the emergency room.”

The Behavioral Health Network of Greater St. Louis told The Post-Dispatch the region lost 42% of its acute care beds for psychiatric patients between 1990 and 2010.

“The emergency room is doing everything they can to care for patients,” Schafer said, “but they also have to triage and prioritize patients.”

Intensive care beds and ER staff must juggle the patient-load of physical and behavioral health emergencies, but the most effective methods for treating these issues are fundamentally different, leaving those suffering from behavioral ailments such as depression or suicidal ideation to wait. This phenomenon creates a treatment “gap,” according to Schafer, which she hopes to bridge with the new clinic on the SSM Health DePaul Hospital campus.

“Folks come in and don’t typically have anywhere near the wait of an emergency room,” Schafer said. “We are there solely to treat behavioral health and substance abuse disorders. When they come in, a nurse will triage them and make sure they don’t have any medical issues.”

The clinic screens for any immediate issues with a patient’s physical health as they are not equipped to deal with medical problems.

“They go right into seeing the master clinician who can spend time talking to them and getting their history; figure out what’s going on, what’s brought them in,” she said. “From there, if they need any medication, they have immediate access to a psychiatric nurse practitioner or a physician that can prescribe them and get them started towards stabilization.”

Once the patient has met with the therapist and the nurse practitioner to intervene and stabilize the situation, they then are given access to resources to mitigate another incident, according to Schafer.

“They’ll be able to get a follow-up care appointment within three days of coming into the urgent care,” she said. “That’s what the community partners are doing for us. We’ll also make sure there aren’t any barriers or social determinants as a health issue.”

Needs, such as transportation and housing or food insecurity, can be addressed for patients to have access to their follow-up appointments.

“The whole process takes, depending on what their needs are,” she said, “maybe an hour and a half or so. Unfortunately, when they’re in the emergency room, they’re there for a very extended period of time.”

It is too early to tell whether the clinic has made an impact on area emergency rooms, but there are reasons to be optimistic, according to Schafer.

“We’ve certainly seen a slight decrease in the DePaul emergency room,” she said. “Which is certainly something that we expected … but it is a metric that we are tracking across the community, not just DePaul.”

Since opening its doors in August, the clinic’s services have only been available to adults, but recent inputs from the community have changed that.

“We’ve gotten a big contingent of calls and requests for services for children and adolescence,” she said. “We’ve fast-tracked our plan to be able to provide that care, and we hope to open up to children and adolescence by the end of the month.”

The biggest challenge the urgent care has faced so far has been making the community aware of its existence.

“We’re working really hard to get the information out there,” Schafer said. “To police departments, to ambulance districts, primary care physicians and the general public and community as a whole. We want to be busy. We want people to know this is a resource that is there for them. They can receive the right type of care, at the time that they need it, with the right providers.”

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