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SALT LAKE CITY — Intermountain Healthcare's emergency departments have seen a 300% increase in pediatric mental health crises in the past 10 years, with an estimated 40% of children with depression not accessing care.
The rise is consistent with the state's struggle with mental health and suicide rates. In Utah, suicide is the leading cause of death among children ages 10 to 17 years old. The state has also consistently ranked among the top 10 states for the highest suicide mortality rates, according to the U.S. Centers for Disease Control and Prevention.
An already ongoing crisis was exacerbated by the COVID-19 pandemic, with the U.S. surgeon general issuing an advisory on the nation's youth mental health crisis in December 2021. That crisis was reflected in data released by Huntsman Mental Health Institute that showed a 32% increase in Utah crisis calls in 2021.
While the prevalence of mental illness among urban and rural areas are similar, the access to mental health resources can vary.
The discrepancy between the rise in crises and lack of access to care can be explained by a variety of factors. Intermountain's Primary Children's Hospital and the Utah Department of Health and Human Services are attempting to a gap in services in several rural counties in Utah's western region.
"This is part of an ongoing effort to grow and provide these additional resources to children and families throughout Utah," said Kim Kettle, director for the Office of Coordinated Care & Regional Supports with the Utah Department of Health and Human Services. "This is still in the beginning stages, and while capacity will be limited, it is an important step forward to ensure all Utahns have access to mental health services."
Intermountain announced the expansion of the Stabilization Mobile Response program to Wayne, Piute, Severe, Millard and Sanpete counties on Monday. The program will operate as a mobile and telehealth program, increasing access to mental health resources outside of emergency rooms.
"Really, it's all about how do we get kids the right treatment that they need in the right place at the right time? The more we can keep kids out of the emergency room and get them to service, whether that's in home or having more urgent clinics and more access to care immediately," said Dr. Lisa Giles, University of Utah Health and medical director of behavioral health for Intermountain Primary Children's Hospital. "Whether it's digitally or in person, it's having programs that can help us divert from inpatient psychiatric hospitalization if that's not needed."
The Stabilization Mobile Response program is designed to provide help in a variety of circumstances. An individual can call 1-833-SAFE FAM for help and a trained professional will answer the call, help the family with de-escalation, and determine services that best fit the family's needs, according to Giles.
Following the initial call, if necessary, a team of behavioral health specialists can travel to the home and create a support plan. Stabilization services can continue for those who are impacted by barriers for up to eight weeks.
"Crisis is sometimes just 15 minutes, but often they last a little longer and how to continue to support through that becomes very important," said Giles.
The program helps address several factors rural areas may struggle with when accessing mental health resources:
Accessibility & availability
One of the most significant challenges people in rural areas face in receiving care is the lack of mental health professionals providing mental health services in those areas, according to a 2018 American Journal of Preventative Medicine study.
Many rural areas may not have mental health behavioral specialists available in their area. If a specialist exists in a rural area, people can face significant wait times or delays in accessing resources due to a shortage of professionals. The expansion of telehealth services can decrease wait times for those seeking to access mental health care in rural areas.
"We kind of adjust to where folks are at. There's a lot that can be done just through a telephone call — in terms of assessing situations, offering resources and helping triage. Even if there's not the bandwidth capabilities to do more than a virtual visit, we can at least start with some of that phone triage and then work on the barriers to help provide those virtual visits as well," said Giles.
Affordability
Costs of accessing mental health resources may be a concern of those in need. The telehealth program is free of cost to those who access it, helping address barriers of cost.
Acceptability
Stigma surrounding mental health and accessing care has been decreasing over time, said Giles. The increased conversations surrounding mental health can help increase awareness of resources and decrease the stigma.
"Even though we've seen significant need for services over the last several years, our suicide rates in the state have not increased — are still too high— but have not increased which to me is hopeful in that we have more help-seeking behavior," said Giles.
"I always tell parents: going to your pediatrician or your primary care provider is a great place to start and ask questions about is this normal? Is this right? Is this your typical teenage years or something else going on? Because it's all part of health," she added.
