Too often, when a person is in the midst of a mental health crisis, they or their loved ones end up calling 911 or driving to the emergency room.
While there’s no question that a mental health crisis can feel like it requires emergency action, a coalition of health care systems, law enforcement organizations, government agencies and advocacy groups known as the East Metro Crisis Alliance wants people in their part of the state know of the many other support options that can be far more helpful and appropriate than calling 911.
To get this message across, the alliance has developed a new full website, one of the nation’s first consumer-focused online resources for people in mental health crises. It guides patrons through the mental health crisis system on the East Side of the Twin Cities and explains ways they or a loved one can get the help they need in the most appropriate place.
In many cases, people who go to emergency rooms for mental health crises end up leaving without the services they’d hoped for, said Roger Meyer, project director of the East Metro Crisis Alliance. He explained that emergency room personnel focus on assessing whether or not an individual in mental health crisis should be admitted, and mentally ill patients are often rushed out of the hospital after hours of waiting to be seen.
Only about 50 percent of people who present to an emergency room in a behavioral health emergency end up being admitted to an inpatient unit, Meyer said. Not what people were hoping for. They don’t know what to do. They know they need help, but usually don’t get it.
The same can happen when someone calls 911 to get help for a loved one in a mental health crisis, Meyer said. While police officers and paramedics have some training in assisting people struggling with mental illness, these situations are often beyond their expertise and, in many cases, taking this route to care may be less direct or effective and sometimes dangerous.
Meyer doesn’t blame people for calling traditional 911 responders in the midst of a mental health crisis. This is a very vulnerable time, he said, but he and his Alliance colleagues want to help people find a more direct path to the help they really need. They hope their site is a clear and simple way to do this.
One of the things we always think about at the alliance is how to get people the right care at the right time, Meyer said. We don’t want people to go to the emergency room unless they are at an emergency room need level. We don’t want people calling 911 unless what they’re looking for is covered by 911.
Joe Clubb, vice president of mental health and addiction operations at Align Health, said the site couldn’t have come at a better time. An increasing number of people experimenting mental health crisis in the state means traditional rescuers feel overwhelmedshe said, and helping people find the most appropriate care for their mental health issues might just help keep the system running a little smoother.
We’ve all made some strides, but none of us have been able to keep up with the overwhelming demand for mental health care, Clubb said. There are many options available to people before an emergency room. We need more resources like this that help people get where they need to go more directly.
Focus on normal people
There are already many online resources designed to help healthcare professionals understand the nuances of the mental health system and how to refer patients to the best care for their particular situation, but until now there have been few if any sites built with mental health . care consumers in mind, Clubb said: There’s really nothing like it out there.
In Minnesota, different regions of the state all have their own mental health crisis systems, networks of social services agencies, first responders and even residential facilities designed to help people in crisis. But ordinary people, or the very people those systems were created for, generally know nothing or, at best, very little about how to navigate them.
Members of the East Metro Crisis Alliance have known about this gap for some time, Meyer said, and have spent many meetings discussing how to demystify the system for mental health care consumers.
It’s such a complex system, Meyer said, with so many assets in so many different areas. For years, alliance members have been discussing different approaches, he added: “We’ve realized that there is no one good resource to get started in the crisis system, and as soon as you try to put together an all-inclusive resource guide, it becomes overwhelming.
The group eventually agreed on the idea of creating a website for people in crisis and their loved ones to go to before contacting traditional emergency responders. They wanted the site, Meyer said, to help people demystify the system and get started on the right track. He explained that he and his colleagues wanted the site’s content to be accessible, written and designed in a style that would appeal to lay people, not healthcare professionals.
To make sure their site contained the most accurate and helpful information, Meyer and his colleagues reached out to a number of Minnesota mental health leaders, including Clubb and Shannah Mulvihill, executive director and CEO of Mental health Minnesotaa mental health advocacy and advocacy organization based in the Twin Cities.
Mulvihill explained that Meyer asked for his help to use language that reflects the lived perspective of people with mental illness. At Mental Health Minnesota, she said, let’s see how people interact with the system, not through the eyes of a hospital or law enforcement lens. Roger wanted my help to see that the final product would be an easy to access place to go for that information.
Mulvihill recommended that the site’s entry be welcoming and non-intimidating. He said he suggested, make sure it’s person-centered. We do not refer to people in the third person. The final product is centered around people’s real experiences and kept very simple.
The site is filled with links to resources for understanding the overall crisis system, ways for users to speak directly to a mental health professional, options for making mental health care appointments, and direct links for immediate help in a mental health crisis.
Clubb said the developers created the site with the idea that users could often be someone trying to help a loved one in the midst of a mental health crisis.
It’s designed largely for a situation of, I need access to care for a family member or loved one, she said. Sometimes the individual in crisis is so overwhelmed. They are struggling just to get out of bed, so they need a friend or family member to step in. While the site could also be directly helpful to a person in crisis, she said, its creators understand that other people may actually be the ones who end up seeking care and resources: It is set up to support the caregiver and support the person seeking care.
This consumer-centric approach makes the site especially useful, Clubb said, and sets it apart from other options. What makes this site unique is that it is written for loved ones, interested people, non-professional consumers. This is the special sauce.
Another element that increases the accessibility of sites is a video sets which were created to guide viewers through the process of using specific mental health resources. In the videos, volunteer actors (Meyer also has a role in one) portray people’s experience as they go through interactions with a range of mental health services, including accessing a crisis shelter bed, setting a psychiatric appointment, entry into Ramsey County detox, have an emergency room visit for mental health or substance use issues, or use peer support services.
Meyer explained that his team created the videos to give consumers an idea of what it might be like to access these services. We wanted the videos to demystify and explain the experience in a one to two minute video because not everyone knows what will happen when you actually call someone for help, she said. Will you have to share all your private information? Will they take your vitals? Will they ask for money? When someone doesn’t know what’s going to happen, it can cause anxiety and they may not act.
In some ways, Clubb said, videos explain the process better than words on a screen. If you’re someone who won’t be engaged through written text, videos are posted in a variety of ways. They provide the information you need to understand, this is how it would be for someone who has had the same struggle I am going through. I’m not alone.
Meyer and his co-creators understand that mental health crises are scary, and when they occur, it can be difficult to think clearly. That’s why people call traditional rescuers so often. With this reality in mind, Mulvihill suggested that it might be helpful for people to visit the site when they’re not in the midst of a crisis, so they are already aware of the resources available and have a better understanding of where to go.
You don’t know what you need until you need it, Mulvihill said. So why not go out front and learn a little more?
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