Colorado kids, teens visiting emergency rooms in mental health crises can now get free therapy

Coloradans increasingly end up in hospital emergency rooms when in severe mental health crises, but once stabilized and sent home, most never go to therapy.

About 70 percent of people don’t see a therapist after an emergency visit, a statistic that mental health advocates blame on a confusing system and lack of guidance available to patients.

But what if trained listeners, the same ones who answer suicide hotline calls, called people after they withdrew from hospital emergency departments and talked them through the process of finding a normal therapist?

That’s the premise behind a Colorado program that has expanded to 73 hospitals statewide and recently partnered with a nonprofit that provides free counseling sessions to young people who don’t have the means to pay for them.

The follow-up project began nearly a decade ago as a pilot program with a few hospitals, including UCHealth University of Colorado Hospital. By pooling funding through a variety of grants, the State Office of Suicide Prevention was able to support the program in 2018 with eight hospitals. It now includes 73 hospitals, both in cities and rural towns, and follow-up specialists have called more than 19,000 patients.

The latest federal grant has enabled the Office of Suicide Prevention to partner with the Second Wind Fund, which since 2002 has paid for therapy sessions for youth up to age 19 who are at risk of suicide. Now, the crisis specialists who make the posthospital follow-up calls can offer not only guidance on how to find a therapist who will take patients, but connect patients with the nonprofit who can arrange and pay for those appointments. .

Rocky Mountain Crisis Partners, which answers the Colorado Crisis Services hotline and calls the 988 National Suicide Hotline dialed in Colorado, has a team of 25 dedicated to the follow-up project. A patient who has been discharged from a hospital emergency room receives a call from a specialist within 24 hours, then a weekly call for the next month or so.

The risk of death by suicide increases in the weeks and months following a person’s visit to the hospital with a mental health crisis. Studies have found that 22% of suicide deaths occurred within 30 days of an emergency hospital visit, while 40% occurred within a year of a trip to the emergency room.

There is evidence that the follow-up project is helping. Based on surveys after six months and one year, people who participated in the program were less likely to return to a hospital or walk-in crisis center. That means their ongoing therapy has helped them manage their anxiety and depression and they’re less likely to end up in a crisis requiring emergency care, said Melody Keown, program manager for Rocky Mountain Crisis Partners.

The program’s origins date back to 2011 when Rocky Mountain Crisis Services began responding to the state hotline. Hotline answering staff soon began making follow-up calls to people who had called in crisis and, a few years later, began the pilot program with the University Hospital, thanks to a grant received from the state Office of Prevention of suicide.

When you’re discharged from an emergency room, you’re given a lot of information and a lot of instruction, Keown said. It is often too much to digest, and therefore people feel overwhelmed trying to set a therapy going. Staff making follow-up calls try to provide patients with information, as well as gently nudge them into sticking to the plan, he said.

They say, “We’ll call you next week and see how that worked out,” Keown said. Not only are they encouraged and informed, but they are being held accountable and have to answer that phone next week. It’s not done in a judgmental way. Support him, to see if they followed up.

The first call lasts up to 30 minutes and the average duration of the subsequent weekly calls is 15 or 20 minutes. Patients can opt out of the program at any time, which is free. We do our best to actively listen and understand everyone’s story,” Keown said.

The program’s specialists don’t make appointments for anyone, but instead encourage people not to give up if it takes a while to find a therapist who will not only accept their insurance, but take on new patients.

A long wait time for a first date is a pretty common experience right now, Keown said.

Prior to working for Rocky Mountain Crisis Services, Keown had the experience of trying to navigate a large, disconnected system when one of his children needed mental health care. His son’s doctors advised him to attend an intensive outpatient program, but the waiting list was nine months long.

I should have kept him safe myself and taken him to therapy he didn’t want to go to he said. Had we known there were other support options out there, we might not have felt lost.

The follow-up project, which has served up to 8,000 people a year, is aimed at children and their parents as well as adult patients. Last year, the program involved 133 parents of children up to age 9 and more than 2,500 young people between the ages of 10 and 24.

For most people, there is an increased risk of suicide after a suicidal crisis, said Lena Heilmann, director of the state’s Office for Suicide Prevention, which is part of the State Department of Public Health and the Environment. Colorado. The project is based on the care contacts model, which has shown that people are less likely to die by suicide if they are being watched by someone.

Someone who checks in with that person who has been suicidal or is experiencing a mental health crisis, to offer only support and assistance with nothing requiring or providing therapy, just caring contact, said Heilmann, who she was drawn to his career because she lost her sister to suicide.

The new partnership with Second Wind Fund pays greater attention to children and teenagers. Suicide is the leading cause of death for young people in Colorado, with recent data showing that one in five high school students have considered suicide. The state suicide rate for children and adolescents ages 10 to 18 is one of the highest in the nation, though the rate has remained stable since 2016.

The nonprofit offers 12 free therapy sessions to youth up to 19 who are uninsured or underinsured. With the new partnership with the state, the goal is to expand the free therapy program to people up to age 24. The latest grant, from the Federal Substance Abuse and Mental Health Services Administration, provides $735,000 each year for five years.

The plan is to expand each year for five years until young people as young as 24 can access free therapy sessions, Heilmann said.

More than 8,000 young people have received mental health care from Second Wind over the past two decades. The fund has received 750 applications since July alone, the most in five years, said Chris Weiss, executive director of the fund.

Parents and caregivers who fear their child may be having suicidal thoughts can find immediate, free, and confidential help through Colorado Crisis Services at 1-844-493-TALK or by texting TALK at 38255.