Bear River Mental Health plan

Bear River Mental Health's President and CEO Beth Smith addressed the Cache County Council and Executive Craig Buttars (left) on Nov. 10, 2020, where she presented the Bear River Area Mental Health Plan and asked for funding approval to continue support for ever-increasing mental health needs.

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Bear River Mental Health is in “dire need” of qualified health care providers in order to keep up with increased calls for service and is expected to receive funding increase to help.

“Almost one in five Utahns struggle with mental illness,” said Bear River Mental Health President Beth Smith. “You’ve probably heard a lot about mental illness lately, because of COVID, and I would dare to venture that because of COVID, those numbers are probably even higher.”

COVID’s impact

At Tuesday’s Cache County Council meeting, Smith presented the Bear River Mental Health Area Plan and updated council members on how services are utilized in the area.

“As June ended, we saw 15% more in our admissions,” Smith said, along with a 30% increase in crisis service.

Though Council Member Dave Erickson questioned the role of the pandemic in the increase, Smith said “it’s hard to tell.”

“Because at the same time, we had Medicaid expansion, and we are the Medicaid provider, you know, and so the number of clients that we’re seeing has gone up,” she said. “So as the number of clients goes up, you would expect that the number of crises will go up as well, but I definitely believe that many of these are related to COVID.”

Attempts and deaths by suicide are still down this year compared with 2019 in the Bear River Health District, according to Charity Jensen, a health educator with the Bear River Health Department, “although this is something that we are constantly watching. Data from this year is still too preliminary to make any hard conclusions.”

And while Bear River Mental Health serves “some of the most severe cases,” Smith said only a handful of the people who die by suicide in the state are clients.

“I would say 75% of the patients we serve suffer from severe mental illness, so you’d think we’d see higher rates of suicides, but we don’t,” she said. “Every time we get the list, and I check to see if there are names who used to be clients, but it’s rare … What that tells me is it’s working.”

Through CARES Act funding, the program was even able to purchase laptops to help serve clients through telehealth services.

Mobilizing the team

Two of the programs Smith is most excited about are mobile crisis teams because they’re unique to the area: the Stabilization and Mobile Response crisis team for youth aged 10-17 and the Mobile Crisis Outreach team serving adults.

Smith said the programs are good “gap fillers” in an emergency, such as providing support to police officers “so that they’re not the untrained caregivers in mental health emergencies,” and can save costs down the road.

“For example, we can send a team out for about $380 per episode, as opposed to if somebody gets hospitalized based on their crisis — that can be as much as … about $9,000,” she said. “It’s also a program that helps divert people, of course away from the emergency rooms and the inpatient units, but also from the jails.”

In September, Bear River Mental Health’s clinical supervisor, Adam Boman, told The Herald Journal the SMR team is instrumental because “there’s no waiting list.”

“Traditionally, they can call a therapist if they need help, but a lot of the time, there’s a wait list for eight weeks,” Boman said. “We provide treatment services for those eight weeks.”

Smith added when a family member needs help, transportation can be an issue.

“They’re both crisis response systems designed to go to where the crisis is,” she said. “If a family member, whether it’s an adult or a child, knows another family member is struggling, they can call a doctor, but if they’re told to bring them in, what are the chances that person can bring them in? A lot of times they’re afraid of the police, or they don’t want to go to the emergency room.”

Bear River Mental Health has offered the youth SMR team for years, but it saw a significant increase in calls after schools reopened in August. The MCOT team was announced earlier in the year but implementation was delayed due to state funding issues after the pandemic hit.

The team has been operational since mid-October, and the goal is to increase to 24/7 service by the end of the year, though the SMR team will likely still only operate until 11 p.m. as data across the state shows the need is greater for adults after that time.

The 24-hour call line is staffed with therapists and is available at (833)SAFEFAM, or (833)723-3326.

Early intervention

Increased access to services may be leading to the lower numbers as crisis centers and expanded telehealth services are experiencing massive upticks in utilization. Though Bear River Mental Health serves 2,300 clients from Box Elder, Cache and Rich counties, the same phenomenon is seen throughout the state.

For example, Citizens Against Physical and Sexual Abuse helped nearly 3,000 more clients through the 24/7 crisis line from March to September this year than during the same period in 2019 — almost an 80% increase.

As with CAPSA, Smith said early intervention is crucial for preventing future deaths.

“If you can start early, you can really impact an individual’s life later,” she said. “It’s easier to do it on the front end than to try and fix an adult that’s really struggling.”

Though suicide is the leading cause of death for Utahns aged 10-17, Smith said 60% are not receiving treatment for mental illness, and it’s the same for “more than half of adults.” This is supported by the most recent Kem C. Gardner Policy Institute and Utah Hospital Association’s mental health report.

“And if that’s not bad enough, we have a provider shortage,” she said, “and Bear River Mental Health is feeling that provider shortage.”

Though the program saw an increase in both crisis calls and admissions, its staff only increased by 7% — and none of them were licensed prior to being hired. Instead, Smith said the trend is to hire students, because they wish to build experience and get training, but they move on to private practice once they’re certified.

To help address the increase in need, the Cache County Council is expected to approve a budget increase of $2,600 for the program — a total of $322,600 from the annual budget — at the council meeting on Nov. 24, despite other areas of budget cuts.

“If we cut the budget a few thousand from our end, we could lose hundreds of thousands of dollars from state and federal funds due to matching requirements,” said Cache County Executive Craig Buttars. “I think there’s a lot of mental health needs. The longer the COVID situation goes on, the more of a need we’ll see in the community. Now is not the time to cut those dollars.”

Help is available for anyone struggling through the National Suicide Prevention Lifeline at (800)273-TALK (800-273-8255), for talk or text, or online at suicidepreventionlifeline.org/chat.

Additional help from CAPSA can be reached at its 24-hour crisis line, (435)753-2500.

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