Op-ed: More to do in Utah's mental health crisis
Deseret News - 6/28/2018
Nearly one in five people in the United States struggles with a mental health condition. Against a backdrop of mass public shootings, escalating opioid addiction and increasing rates of depression, it’s disheartening to read about the suicides of fashion designer Kate Spade and chef, author and television personality Anthony Bourdain. Clearly, wealth alone does not provide protection from the ravages of mental illness, but it does garner the headlines. So did a recent report from the Centers for Disease Control and Prevention indicating that 49 states saw a 25 percent increase in suicide rates from 1999 to 2016. Suicide prevention is a complex, multifaceted issue. The dramatic shortage of psychiatrists and other mental health providers throughout the country is one of many severe hurdles to accessing care.
Utah is not removed from this crisis, and our rapidly expanding population suffers from a higher rate of mental illness than the U.S. average. Nationally, the Bureau of Labor Statistics estimates only 311 mental health providers per 100,000 people. In Utah, it’s 209 per 100,000. Nationally and locally, there are not enough inpatient beds and treatment programs for good mental health care.
University of Utah Health aims to be a leader in improving access to mental health specialists and closing the gap that exists between medical and mental health treatment. Already, we’re developing innovative programs to help the existing pool of mental health providers care for a greater number of people throughout our community by expanding the number of physicians in our psychiatry residency program and continuing to recruit, hire and train skilled mental health providers. We are also expanding campus and community mental health facilities.
Among the community programs making a difference is the Giving Access to Everyone program, which extends mental health services to children and adults by pairing primary care physicians and psychiatric specialists for consultation electronically. Through this service, we can provide high-quality care to families and children while lowering costs and maintaining most treatment in their home. U. of U. Health has also invested in mental health integration, where we place therapists and psychiatrists alongside primary care clinicians in the clinic. These innovative programs provide tremendous value to patients but, unfortunately, they are not adequately reimbursed by insurers.
At the University Neuropsychiatric Institute, we’ve teamed up with Salt Lake County, SLCo Optum and Utah Division of Substance Abuse and Mental Health to provide a crisis line at 800-273-8255 to keep our family members, friends and neighbors safe statewide 24/7. The crisis line is Utah’s hub for the National Suicide Prevention Lifeline. Licensed clinicians provide prompt and compassionate intervention, plus referrals and follow-up services. The line takes about 50,000 calls a year and averages three to five active rescues per week. Another 14,000 calls a year, on average, are answered by the Warm Line. On this line, Salt Lake County residents not in crisis can receive support, engagement or encouragement from peer specialists.
When highly trained professionals determine that a crisis line caller needs face-to-face intervention, our mobile team meets county residents where they are, averaging more than 325 encounters a month. Youth and adult service teams are available 24/7 to offer support to individuals, families, schools, treatment providers and first responders.
A collaboration between the state and academia developed a mobile phone app specifically designed for schools: the SafeUT Crisis Text and Tip Line. The Utah Legislature, the State Board of Education, the Attorney General’s Office, law enforcement, the Division of Human Services and the University Neuropsychiatric Institute all contributed to the app, which is in wide use across the state.
The service provides real-time crisis intervention to students through texting and a confidential tip program — right from a smartphone. Licensed clinicians in a 24/7 call center respond to all incoming chats, tips and calls. They assist with emotional crises, bullying, cyberbullying, drug and alcohol problems, relationship problems and mental health or suicide-related issues. All tips are confidential. Students are encouraged to send tips on threats of violence at school and other emergencies.
Unfortunately, traditional outpatient services are not always enough. We have expanded inpatient services, including developing a nationally recognized Comprehensive Assessment Treatment program for children and adolescents facing complex mental health issues. The program provides a full spectrum of intermediate services, including residential care, day treatment, intensive outpatient and substance abuse services. The University Neuropsychiatric Institute has the Treatment Resistant Mood Disorder Clinic, which provides a full range of neurostimulation treatment.
Clearly more needs to be done. This is a critical problem that faces our nation, our state and our individual families. As Utah’s only academic medical center, we are looking to create more innovative yet practical programs to promote healthier minds and better lives. But we cannot do this alone. We welcome collaboration, input and ideas from government leaders, community organizers, religious leaders, teachers and you. We are a community. We are stronger together. We are Utah and we can lead the country in solving the mental health crisis.
CREDIT: Howard Weeks