Waiting weeks for a mental health appointment? You don't have to with urgent care program
Stephanie Dickrell
ST. CLOUD — The death of a loved one. The loss of a job or a business. Childhood bullying. The loss of a pet. Financial difficulties.
Any one of these events has the potential to throw our daily lives out of wack, causing or triggering mental health issues, including depression and anxiety.
But in St. Cloud, you could wait weeks or months to get an initial appointment.
Marc Van Herr doesn't think that's acceptable. He is executive director of the Beautiful Mind Project, which raises awareness, educates the public and works to reduce stigmas associated with mental illness.
Van Herr thinks mental health problems should be treated just as we would treat a broken arm or severe stomach flu — as soon as possible.
"I was just so frustrated with having to wait so long for an appointment and how completely unacceptable that would be if it was physical health problems," Van Herr said. "What if you had a cold today and the doctor said they'd see you in the middle of September? How does that work? You would freak out."
Van Herr, who has bipolar disorder, created the Beautiful Mind Project about two and a half years ago. Since then, the nonprofit has created free educational seminars and given two college scholarships.
For the last eight months, the project has managed the urgent mental health care program.
"It's kind of like the crown jewel in what we've accomplished in two years," Van Herr said. "It was an opportunity to fill a glaring hole in the mental health field here."
The program is for those in between problems — not serious enough to be an emergency where law enforcement need to be called, but big enough that the patient doesn't feel OK waiting for that long-off clinic appointment.
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"The goal of this is to capture as many people as we can before they reach that crisis level," Van Herr said.
Kelly Cook agrees. She is is a licensed independent clinical social worker and works at Cook Counseling, LLC in St. Cloud.
"The way I like to think about is kind of like that minute clinic," Cook said. "You go in for cuts and scrapes and then possibly follow up with your doctor afterward, if you need to."
She was one of the first providers to offer appointments.
"When (people) call up, they’re wanting help right then," Cook said. "Because it takes a lot of courage for them to call and ask in the first place."
And it may catch some people the current system doesn't.
"They don’t feel like their symptoms are really bad enough to go to the ER or ... call the crisis line," Cook said, such as the suicide hotline.
"We're also sparing the resources of the emergency room and the crisis team which are already overloaded with severe crises."
How does it work?
It sounds simple.
"We take people who have a need and match them with providers who have openings," Van Herr said. And they do so within a few days.
There are only a handful of places which do urgent mental health care and they're all in the Twin Cities, he said. That makes them inaccessible to a lot of people.
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Van Herr wanted his program to have more flexibility, recruiting providers from all over Central Minnesota.
"That whole area of urgent care for mental health, it's fairly new. It's pretty young," Van Herr said. "There's not a well-developed (model) that's out there. So we've had to feel it out and figure it out as you go... It is my own creative brain-child."
People call a number and set up an appointment to see a mental health professional that day or the next day.
So how does Van Herr make it work?
By partnering with smaller mental health providers, people work as solo practitioners or as part of a smaller team.
Van Herr promises to give them business. In exchange, the provider holds open a certain number of spots per week for urgent care appointments.
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For example, a practice may have eight openings on any given week. They might promise Van Herr to hold four of those openings for urgent care patients.
The provider also pays a small fee to the Beautiful Mind Project for facilitating the appointment, which helps sustain the program. Van Herr uses it to sustain the back-end technology needed to run the hotline and to advertise its existence.
Once the appointment is made, the referred patients aren't treated any differently than other patients.
The appointment is paid for just as any mental health visit would be, using the patient's private insurance, Medicaid or sometimes using a sliding-fee scale.
For the provider, this helps fill spots that may otherwise be left open, Van Herr said. Advertising is expensive, he said.
"We're in charge of shaking the trees, getting folks that need help aware of the program," Van Herr said.
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In some cases, people referred by the urgent mental health care line become long-term patients. Sometimes, they don't.
For others, it may be a one or two session "pit stop" or "oil change," Van Herr calls it.
Expanding mental health care access in volume and location
Right now, the program can accommodate 25 to 30 appointments a week, Van Herr said. Typically, 10 to 15 of those spots get used by people who call in.
Once the program is consistently filling most of the available appointments, he'll bring in more providers.
To spread the word about the program early on, Van Herr met with people from places likely to encounter people in need of mental health care, including the Central Minnesota Sexual Assault Center and the Place of Hope.
"They were sending clients right away," Van Herr said.
By the end of the year, he hopes to have as many as eight to 10 locations with providers who have urgent care openings. The opportunity for easy expansion is one of the things he likes most about the model.
"It doesn't cost hardly anything to run, and it's scaleable," he said. He's aiming to find providers in smaller cities, including Little Falls, Milaca, Princeton, Monticello, Big Lake and Sauk Centre.
He hopes eventually appointments will be available outside traditional business hours, to increase accessibility.
So far, it's working
Van Herr hasn't had any trouble finding providers to be part of the program.
"I've got a back log, a couple of providers on standby," he said.
Cook says the program is working well for her practice.
"I had tried... an urgent care or emergency walk-in clinic in the past but it never took off," Cook said. "So I thought it was a great idea, and Marc had some good plans for it."
Cook said many of the appointments are for people experiencing Post-Traumatic Stress Disorder symptoms from past traumas.
"(People) were feeling, like, 'OK, I'm at the end of (my) rope, I'll give it a try,' " Cook said.
Most came in for a few visits, resolved the issue and moved on, she said.
"It's designed for people... having mini-crises," Cook said. "Whether it be a pending divorce or a loss of a pet or an increase in their mental health symptoms."
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Some have gone on to become patients. Many do ask about access to a psychiatrist.
"Sometimes, somebody is just so overwhelmed by events going on in their life, they just need somebody to vent to and to help make a plan of what to do," Cook said.
The program is available to kids, too.
"If kids are struggling in school, or they’re being bullied ... they don’t quite have the coping skills, anger management skills to get along with people, that’s a usually the biggest thing that we see people for," Cook said.
What's next? Van Herr has plans.
Right now, the phone number rings through to a designated provider. But as they add more sites and more providers, they will need a centralized phone service to take calls and make appointments.
Telemedicine may be an option in the future, serving areas without providers and bringing in much-needed psychiatric services.
"If nothing else, the urgent care program would be able to be a bridge until they can get in and see a psychiatrist," Van Herr said. "Maybe you go see one of those providers... you get some tools to manage your symptoms and you have a better opportunity for success."
For more information
If you or someone you know is in need of urgent mental health care, call 320-216-3300 to make an appointment, available that day or the next day.
For more details about urgent mental health care, visit thebeautifulmindproject.org/UrgentCareforMentalHealth.html.
For more about the Beautiful Mind Project, visit thebeautifulmindproject.org and facebook.com/thebeautifulmindproject.
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