Intensive virtual therapy and Colorado mental health clinics found wanting

December 7, 2021

Good morning MindSite News Readers. In today’s newsletter, you’ll read tips for strengthening relationships with your kids. You’ll also hear about unforeseen benefits of moving intensive mental health care online during COVID, as well as a theatre group for traumatized veterans and first responders and an investigation into Colorado’s mental health safety net clinics.

Even intensive mental health therapy went virtual during the pandemic

At the beginning of the pandemic, the idea that mental health therapy could be delivered virtually was off-putting to many patients. But after nearly two years of practice, patients are comfortable with online therapy even in intensive mental health programs, according to an article by STAT news. In two intensive programs for Obsessive Compulsive Disorder, for example – one at McClean Hospital in Massachusetts and the other at UCLA in California – translating routines, exposure therapy and coping skills to a virtual landscape conferred unexpected benefits. Suddenly clinicians had a window into the worlds that might be triggering anxiety in their patients and ideas for new ways to help them. For someone who needs to repeatedly check the stove, for example, a clinician could walk the patient through a series of exposures to loosen the grip of that compulsion.

But virtual mental health care also has its downside. Acadia Healthcare, the country’s largest standalone behavioral health provider, scaled up its efforts to provide virtual services and has been experimenting with online versions of its intensive programs for some of the 70,000 patients it serves each day. “Some people really, really need to be with other people physically to benefit,” said Michael Genovese, Acadia’s chief medical officer. “Five days a week, five hours a day on the computer virtually is quite a bit for a lot of people.”

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Colorado mental health centers: Paid more to provide less care?

An investigation by the Colorado News Collaborative of Colorado’s mental health delivery system reveals that the state’s mental health safety net clinics are turning away or delaying care to many who sorely need it, according to an article from the Colorado News Collaborative. The report examined 17 mental health centers around the state that collectively receive $437 million in state funds to provide care to the most vulnerable Coloradans. It found that some clinics made people with severe mental illness wait months for an appointment; that they often delayed filling needed prescriptions, sending patients into a downward spiral; that some had no Spanish-speaking staff members even though they served large numbers of Latino immigrants; and that some were paid for programs they never provided.

In one case, a case manager at a center in Summit County was told to stop treating a client with severe mental health problems because he had made racist comments. Shortly after his treatment was halted, the client killed himself. “I blame myself for that every single day,” said the case manager, who quit after the suicide.

The investigation also revealed that reimbursement rates for the safety net clinics far exceeded reimbursement rates for independent clinicians who also serve Medicaid patients. Why? The answer lies in a formula pushed by the clinics’ trade association and agreed upon by the state that “effectively creates an incentive for centers to be less efficient with their spending and to limit or even refuse clients care,” according to the News Collaborative. “It is hard to imagine how that formula is in the best interest of Coloradans, especially when there are so many people waiting for care,” says Nancy VanDeMark, former director of the Colorado Office of Behavioral Health, who now works as a consultant.

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Parents: Don’t be afraid to let children fail once in a while

What do children really need from parents to thrive as adults? For the last eight years, the Minneapolis-based Search Institute has been investigating that and says parents should make ample room for failure, according to an article in Greater Good Magazine. Other findings include showing caring by being reliable, showing up when you say you will, letting kids know you believe in them and actively listening when your child is talking to you – something in too-short supply in an era of parents glued to IPhones. All good advice, especially the reminder to support kids through their successes and failures to help them grow – something especially valuable in the “everyone’s a winner” era. “Until young people encounter challenging perspectives and issues, they may never learn to articulate their own values effectively,” the authors write. “And it’s best for them to do so in the context of a trusting relationship.”

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Beauty 2 The Streetz uses historical community wisdom to help homeless

Ask Shirley Raines what the root cause of Los Angeles’ homeless problem is, and she’ll tell you it has everything to do with inequities. Raines is the founder of Beauty 2 The Streetz, a nonprofit that provides hot meals, haircuts and makeovers to people on the city’s Skid Row. She told the Los Angeles Times the work lifts her spirits, and that volunteerism was ingrained in her by the powerful women she grew up with in Compton. “If your parents were at work, my grandmother was watching you,” she said. “If you couldn’t eat, my grandmother was feeding you.” Aracelly Cauich is cut from the same cloth. She spends a lot of her free time at Hollenbeck Park in Boyle Heights giving homemade tortas to homeless people she has befriended there. The spirit exemplified by these women may be a reason for an interesting finding in a recent LA Times poll on homelessness. It found, according to the Times, that while Blacks and Latinos were more likely to have experienced homeless or to know someone who had, “they were also more optimistic about solving homelessness than their white and Asian American counterparts.”

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Theater offers traumatized veterans and first responders connection and healing 

At a theater in South Australia, participants might share a love of acting, but their connections stem from working in the military or law enforcement. The Theater of Change gives participants a way to explore their own trauma through acting, according to an article on the digital platform InDaily. “Because I knew the people participating were from very similar backgrounds and had similar stories, there’s an instant trust there,” said one participant who suffers from post traumatic stress disorder from her work as a police officer. 

The process of participating breaks down barriers, even in those reluctant to share, the authors observed. “By about week three, you’re really starting to see people come out of themselves,” says Sharon Mascall-Dare, a veteran who now works as a peer support worker for the theater group. “You see them share moments with other actors as we’re given tasks to perform, scenes to act out. You notice that people in the room start to connect with others and they’re finding a place of mutual support where they can just be themselves and relax.”

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If you or anyone you know is considering suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255. And if you’re a veteran, press 1.

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