>> BY DEFAULT, JAILS HAVE BECOME THE TREATMENT ENTRY POINT FOR MANY MENTALLY ILL PATIENTS EXPERIENCING ACUTE EXACERBATIONS.

THIS IS NOT RIGHT.

STAY WITH US AS Dr. LINDSEY JASINSKI AND MARK WOODS TELL US HOW EMPATH IS CHANGING THIS PARADIGM NEXT ON "KENTUCKY HEALTH."

>> "KENTUCKY HEALTH" IS FUNDED IN PART BY A GRANT FROM THE FOUNDATION FOR A HEALTHY KENTUCKY.

>> IN A DECEMBER 2023 PEW ARTICLE ENTITLED AMERICA'S MENTAL HEALTH CRISIS, AUTHOR Dr. THOMAS INSEL DESCRIBED THREE OVERLAPPING MENTAL HEALTH CRISES, A YOUTH MENTAL HEALTH CRISIS AND 2 SERIOUS MENTAL ILLNESS WHICH INCLUDES SCHIZOPHRENIA AND BIPOLAR DISEASES AND THREE, THE ONGOING SUBSTANCE USE AND ADDICTION CRISIS.

THE NATIONAL INSTITUTE OF MENTAL HEALTH, WHICH DESCRIBES TWO MAJOR CATEGORIES OF MENTAL ILLNESS, ONE IS "ANY MENTAL ILLNESS" AND TWO THE SECOND IS "SERIOUS MENTAL ILLNESS."

IN 2022 IT WAS ESTIMATED THAT 15.4 MILLION U.S.

ADULTS AGED 18 AND OLDER OR 6% OF OUR POPULATION HAVE A SERIOUS MENTAL ILLNESS, SIGNIFICANT ENOUGH TO CAUSE FUNCTIONAL IMPAIRMENT, SUFFICIENT ENOUGH TO INTERFERE WITH NORMAL ACTIVITIES.

IF 6% OF OUR POPULATION IS EXPERIENCING SERIOUS MENTAL ILLNESS, IT BEGS THE QUESTION OF WHERE ARE THESE PATIENTS WITH ACUTE EXACERBATIONS OF THESE ILLNESSES BEING SEEN.

FOR FAR TOO MANY, THE ANSWER IS EITHER IN THE EMERGENCY ROOMS OR WORSE, OUR JAILS.

THE PARADIGM MAY BE CHANGING, THANKS TO A NEW PROGRAM HERE IN KENTUCKY CALLED EMPATH, OR EMERGENCY PSYCHIATRIC ASSESSMENT HEALING.

TO DISCUSS THIS AND OUR MENTAL HEALTH CRISIS, WE HAVE TWO GUESTS, THE FIRST IS PSYCHOLOGIST Dr. LINDSEY JASINSKI, Dr. LINDSEY JASINSKI IS THE CHIEF ADMINISTRATIVE OFFICER AT EASTERN STATE HOSPITAL U.K. HEALTHCARE AND OUR SECOND GUEST IS Dr. MARK WOODS.

Dr. WOODS IS THE EASTERN STATE HOSPITAL CHIEF OF NURSING DIRECTOR AT U.K. HEALTHCARE.

THANK YOU BOTH FOR BEING WITH US.

AND Dr. WOODS, I THINK I MESSED UP YOUR TITLE.

WHAT'S THE REAL TITLE FOR YOU.

>> CHIEF NURSING OFFICER AT U.K. HEALTHCARE Dr. KEVIN MARTIN I HOPE THERE IS NOBODY OVER THERE AT U.K. GETTING NERVOUS THAT I PUT YOU TO THE TOP OF THE LIST.

>> YOU JUST GAVE ME A PROMOTION.

>> A GOOD PAT ON THE BACK BUT NO MONEY WHATSOEVER.

WE TALK ABOUT MENTAL HEALTH.

ONE OF THOSE THINGS WHERE ALMOST LIKE THE SUPREME COURT JUSTICE SAID PORNOGRAPHY, YOU KNOW IT WHEN YOU SEE IT.

WHAT ABOUT MENTAL HEALTH.

IS IT SOMETHING THAT YOU KNOW WITH WE HAVE IT OR KNOW WHEN WE DON'T HAVE IT?

LINDSSEY WHAT WOULD YOU SAY.

>> WHEN YOU ARE TALKING ABOUT SYMPTOMS OF DEPRESSION AND ANXIETY, WE KNOW WHEN WE HAVE THAT.

WE EXPERIENCE, IT FEELS BAD, RIGHT?

AND YOU NOTICE THAT YOU CAN'T DO THE THINGS THAT YOU WANT TO DO DAY TO DAY.

SERIOUS MENTAL ILLNESS IS DIFFERENT IN THAT IT INCLUDES BIPOLAR DISORDER AND SCHIZOPHRENIA AND MANY TIMES ONE OF THE SYMPTOMS OF THE DISORDERS IS A LACK AFTER WEARNESS THAT SOMETHING IS DIFFERENT OR SOMETHING IS GOING ON.

SOMETIMES IT'S THE FAMILY MEMBERS OR LOVED ONES, FRIENDS THAT NOTICE SOMETHING HAS CHANGED WITH THAT PERSON FIRST AND THAT'S WHY WE HAVE SYSTEMS OF CARE SET UP TO GET THOSE FOLKS INTO TREATMENT TO BE ABLE TO ADDRESS THOSE CONCERNS.

>> WELL, MARK, IN THE ABSENCE OF A SCREENING TOOL FOR MENTAL ILLNESS, HOW DO YOU KNOW WHEN SOMEONE IS STARTING TO SHOW SIGNS OR SAY HEY, THIS MIGHT BE A MENTAL ILLNESS GOING ON?

>> YEAH, WAYNE, IN SOME OF THE THINGS YOU TALKED ABOUT EARLY ON, WHEN YOU SAID SEVERE MENTAL ILLNESS, SEA VEER AND PERSISTENT.

SO IT'S HOW LONG IS THIS LASTING?

HOW LONG HAVE THE SYMPTOMS LASTED?

WHAT IMPACT HAVE THEY HAD ON YOUR LIFE, EITHER YOUR JOB, MAYBE YOU ARE HAVING A HARD TIME GOING TO WORK OR MAYBE YOU ARE MISSING EXCESSIVE APARTMENTS OF WORK OR HAVING-- EXCESS EF AMOUNTS OF WORK OR PROBLEMS AT WORK.

AND YOUR SOCIAL CONNECTIONS AND RELATIONSHIPS.

IS IT SEVERELY IMPACTING THOSE?

WE'LL TALK LATER TODAY ABOUT OUR NEW PROGRAM, THE EMPATH PROGRAM, BUT JUST HOW OFTEN TIMES THOSE THAT HAVE EXPERIENCES WITH THESE MENTAL ILLNESSES OR BREAKDOWNS, THEY DON'T ALWAYS HAVE-- THEY DON'T ALWAYS HAVE A PLACE TO GO, JUST TO SAY AM I OKAY?

AM I DOING OKAY?

AND SO OFTEN TIMES THESE INDIVIDUALS HAVE THE EMERGENCY ROOMS OR EVEN FEWER RESOURCES TO BE ABLE TO GO AND GET CHECKED OUT OR GET KIND OF AN UPDATE.

>> SO LINDSEY, 6% OF THE POPULATION, OVERESTIMATION OR UNDER ESTIMATION OR ON THE BUTTON?

>> I THINK IT'S PRETTY CLOSE.

WAS WE KNOW BECAUSE OF STIGMA, MANY PEOPLE DON'T SEEK SUPPORT AND THEY MAY MEET CRITERIA FOR ONE OF THOSE DIAGNOSES AND WE DON'T HAVE DATA THAT CAPTURE THOSE INDIVIDUALS BECAUSE THEY HAVEN'T SOUGHT HELP.

WE KNOW THAT IN MANY AREAS, KENTUCKY ESPECIALLY, WE HAVE DESERTS WHERE THERE ARE FEWER MENTAL HEALTH PROFESSIONALS AVAILABLE.

AND SO WE ARE RELYING ON PRIMARY CARE CLINICIANS MANY TIMES OR OTHER MEDICAL PROFESSIONALS TO HELP DIAGNOSIS THESE MENTAL DISORDERS.

SO IN SOME SENSE, IT'S PROBABLY AN UNDERESTIMATE.

>> WHERE ARE WE AS FAR AS NUMBERS IN KENTUCKY?

>> KENTUCKY MIMICS THE NATIONAL AVERAGES FOR SEVERE MENTAL ILLNESS.

ABOUT 4 TO 6% OF KENTUCKIANS HAVE A SEVERE MENTAL ILLNESS.

AND IN KENTUCKY IN GENERAL, WE TEND TO BE HIGHER THAN THE NATIONAL AVERAGE IN TERMS OF INDIVIDUALS WHO HAVE ANY MENTAL ILLNESS OR HAVE HIGH LEVELS OF MENTAL DISTRESS.

MANY COUNTIES IN KENTUCKY WHERE NEARLY 40% OF THE POPULATION SAYS THAT THEY HAVE HAD MORE DIFFICULT DAYS IN THE LAST MONTH THAN GOOD DAYS.

>> IS THERE-- WE ARE NOT A RICH STATE, AND I'M NOT SAYING THAT RICH VERSUS POOR IS GOING TO INFLUENCE THIS, BUT BEING THAT WE ARE ON THE LOWER END OF THE ECONOMIC SCALE, DO YOU TEND TO FIND IT MORE OF A PROBLEM IN LOWER INCOME GROUPS?

OR IN STATES?

>> MENTAL DISTRESS, SURE BECAUSE MANY OF THOSE PSYCHOSOCIAL DISTRESSES LEND TO STRESS.

LACK OF ADEQUATE FOOD, INABILITY TO TAKE YOUR FAMILY TO THE DOCTORS OR SCHOOLS, IT CAN EXACERBATE VULNERABILITY TO MENTAL DISTRESS.

SUBSTANCE USE IS ANOTHER ONE OF THOSE.

KENTUCKY HAS VERY HIGH RATES OF SUBSTANCE USE AND THAT CAN EXACERBATE WHAT PLIGHT HAVE BEEN BASELINE SYMPTOMS THAT TURN INTO A MORE SERIOUS MENTAL ILLNESS.

>> DO YOU SEE THE SAME THING?

>> INTERESTINGLY ENOUGH WE TALK ABOUT SMI IN 4 TO 6%.

>> SERIOUS MENTAL ILLNESS.

>> YES.

BUT WHAT IS INTERESTING IS THAT IN OUR JAILS AND PRISONS AND I THINK THAT WAS IN YOUR TEASER, WE SEE A MUCH HIGHER RATE OF SMI AMONG THAT POPULATION.

WE SEE ANYWHERE FROM 15 TO 30%.

AND SO YOU ARE TALKING ABOUT A SIGNIFICANT NUMBER OF PEOPLE THAT ARE THERE.

AND IRONICALLY ENOUGH, THERE ARE MORE PEOPLE WITH SMI IN OUR PRISONS AND JAILS THAN ARE ACTUALLY IN OUR STATE HOSPITALS.

SO THAT'S KIND OF-- IT'S NOT-- IT'S MORE OF A NATIONAL SORT OF THING.

BUT A LOT OF STATES HAVE DONE AWAY WITH THEIR STATE HOSPITALS AND WHAT NOT.

BUT YEAH, THERE IS MORE PEOPLE WITH AN SMI IN PRISONS THAN THERE ARE THIS STATE HOSPITALS.

THE OTHER PIECE I WOULD, I THINK THAT IS SUPER IMPORTANT TO APPRECIATE IS THAT WHY IS THAT A PROBLEM?

WELL THAT'S A PROBLEM BECAUSE PEOPLE AREN'T BEING TREATED.

THERE IS VERY FEW TO VERY LITTLE RESOURCES PROVIDED TO JAILS AND PRISONS FOR THE TREATMENT OF MENTAL ILLNESS.

NOW THERE IS A LOT GOING ON.

BUT IT'S VERY, VERY MUCH UNDER RESOURCED AND IT'S NOT EVEN COORDINATED OFTEN TIMES.

IT'S NOT UNCOMMON TO HEAR STORIES AT THE STATE HOSPITAL WHERE WE WORK WHERE PATIENTS HAVE COME TO US AND THEY'VE BEEN IN THE JAIL SYSTEM FOR SEVERAL MONTHS EVEN.

AND WE GET THEM AND THEY ARE JUST ABSOLUTELY-- THEY'RE IN SIGNIFICANT CRISIS.

VERY UNSTABLE.

AND THEY HAVE BEEN THAT WAY FOR SEVERAL MONTHS NOT RECEIVING TREATMENT.

>> FROM WHAT YOU WERE TALKING ABOUT WITH 30% OF THE POPULATION IN A JAIL HAVING SOME FORM OF MENTAL ILLNESS, ARE YOU IMPLYING THAT THIS GROUP, THIS POPULATION IS MORE LIKELY TO COMMIT A CRIME OR IS IT THAT THEY ARE IN SITUATIONS WHERE THEY MAY BE PRONE TO BE ARRESTED?

>> SO IT'S INTERESTING.

I WOULD SAY THAT THIS IS A POPULATION THAT IS ACTUALLY MORE AT RISK FOR BEING VICTIMS OF CRIMES, BEING SORT OF-- VIOLENCE CERTAINLY, MORE PRONE TO VICTIMS OF VIOLENCE AND ALSO JUST EXPLOITATION EVEN.

BUT I THINK WHAT HAPPENS IS AS THE DESERTS, I THINK THAT LINDSEY TALKED TO YOU A ABOUT EARLIER, OCCUR, THERE IS JUST NOT A LOT OF PLACES FOR PEOPLE TO GO AND GET THE CARE.

SO THEY FIND THEMSELVES IN JAILS AND PRISONS BECAUSE THEY'RE NOT GETTING TREATMENT.

AND THEY GET PICKED UP FOR SOME OF THE SMALLER CRIMES OR MAYBE THEY'RE INVOLVED IN THE LARGER CRIMES BECAUSE THEY DON'T HAVE A SUPPORT SYSTEM.

>> NOT NECESSARILY THAT A PERSON WHO IS MENTALLY ILL IS MORE LIKELY TO COMMIT A CRIME.

PEOPLE SAY I DON'T WANT A FACILITY IN MY NEIGHBORHOOD BECAUSE IT BRINGS THE CRIMINAL ELEMENT.

I WANT TO MAKE SURE WE ARE DISPELLING THAT.

>> MAYBE WE TALK A LITTLE BIT ABOUT GUN VIOLENCE GETS PULLED INTO THIS, RIGHT?

AND WHAT WE KNOW-- THERE WAS A SIGNIFICANT STUDY FROM THE AMERICAN JOURNAL OF MEDICINE A COUPLE YEARS BACK, WHERE THEY TOOK A LOOK AT A FEW THINGS THEY LOOKED AT THE UNITED STATES AND COMPARED IT TO U.K. AND AUSTRALIA AND LOOKED AT GUN OWNERSHIP AND MENTAL ILLNESS AND WHAT WERE THE RATES OR THE INCIDENTS OF GUN VIOLENCE AS A RESULT?

AND SO WHAT THEY FOUND WAS THAT THE UNITED STATES OBVIOUSLY HAS ABOUT 10 TIMES THE AMOUNT OF GUN OWNERSHIP THAN THE OTHER TWO.

NO SURPRISE.

BUT THE SECOND PIECE THAT THEY LOOKED AT WAS THE RATE OF MENTAL ILLNESS WERE VIRTUALLY THE SAME, EXACTLY THE SAME.

BUT THE RESULTS WERE THE UNITED STATES HAD ABOUT 10 TIMES THE AMOUNT OF VIOLENCE OR GUN VIOLENCE RELATED COMPARED TO AUSTRALIA AND THEN U.K., IT WAS 40 TIMES MORE.

AND SO REALLY IT WAS THE MAJOR FACTOR WAS SORT OF GUN OWNERSHIP AT THAT POINT.

AND IT WASN'T MENTAL ILLNESS BECAUSE THEY HAD THE SAME RATES.

>> MARK, WE ARE GOING MAKE SURE TO PUT YOUR ADDRESS DOWN SO THE GUN OWNERS CONTACT YOU AND NOT GOING TO COME AFTER ME ON THAT ONE.

>> NOT AT ALL.

I'M A GUN OWNER.

>> IT IS AN INTERESTING POINT THAT YOU RAISE.

>> SAME RATES OF MENTAL ILLNESS.

>> IT GOES AGAINST THE CONCEPT THAT EVERY TIME SOMEBODY COMMITS A CRIME WITH A GUN, THEY'RE NOT MENTALLY ILL. >> EXACTLY.

>> AND SO TELL ME, YOU GUYS, I WANT TO TALK A LITTLE BIT ABOUT THE STIGMATISM ASSOCIATED WITH MENTAL ILLNESS.

WE RECENTLY HAD A CASE IN NEW YORK WHERE A GENTLEMAN, WHO HAD SOME MENTAL ILLNESS, VIGILANTE, FELT HE WAS COMING TO THE RESCUE OF PEOPLE AND GOT A LITTLE OVER EXUBERANT, I THINK.

I WILL LEAVE IT AT THAT.

BUT WE OFTEN TIMES HAVE A PERCEPTION OF MENTALLY ILL AND BEING DANGEROUS.

SO WHAT IS THE REALITY?

EVEN WHEN WE LOOK AT THE MEDIA, THEY'RE OFTEN PORTRAYED THIS WAY.

>> YEAH, SO UNFORTUNATELY THAT HAS BEEN THE HISTORY OF HOW MENTAL ILLNESS HAS BEEN PORTRAYED IN THE MEDIA AS SOMEONE TO BE FEARED, SOMEONE DANGEROUS AND UNPREDICTABLE IN THEIR BEHAVIOR WHAT WE ACTUALLY KNOW IS THAT OF ALL THE VIOLENCE, ONLY ABOUT 4% OF THAT IS RELATED TO MENTAL ILLNESS AT ALL.

SO THE VAST MAJORITY OF VIOLENCE IS NOT RELATED TO MENTAL ILLNESS.

BUT WE DON'T SEE SOME OF THESE HEALING STORIES, THE RECOVERY STORIES, THE THINGS THAT SHOW US THAT MENTAL ILLNESS LOOKS DIFFERENT.

MENTAL ILLNESS CAN LOOK LIKE SOMEONE GOING TO WORK EVERY DAY, TAKING CARE OF THEIR FAMILY, OWNING THEIR HOME AND SUCCESSFULLY IN RECOVERY AND ENGAGED IN TREATMENT.

AND SO I THINK IT'S IMPORTANT THAT WE UNDERSTAND THAT WHILE THE MEDIA HAS SOMETIMES PORTRAYED MENTAL ILLNESS AS VIOLENCE, THAT IS NOT THE WHOLE STORY.

AND IN FACT INDIVIDUALS WITH MENTAL ILLNESS REALLY, LIKE MARK HAD MENTIONED ARE MUCH MORE LIKELY TO BE VICTIMS OF CRIME THAN TO PERPETUATE VIOLENCE.

>> IT SEEMS LIKE, YOU KNOW, WHEN WE OPENED UP SOME OF OUR INSTITUTIONS, PEOPLE DID NOT WANT FOLKS WHO HAD THE LABEL OF A MENTAL ILLNESS IN THEIR NEIGHBORHOOD BECAUSE THEY SAID THEY WERE GOING TO CAUSE PROBLEMS.

THAT'S NOT REALLY IT.

>> THAT'S ALL THEY SEE THOUGH, WAYNE, RIGHT?

THERE WAS A STUDY, RECENT STUDY THAT TOOK A LOOK AT MOVIES AND TV SHOWS AND THE DEPICTIONS, ACTUAL DEPICTIONS OF MENTAL ILLNESS.

AND OVERWHELMINGLY 72% WERE DEPICTED IN A VERY VIOLENT MANNER.

SO WHEN PEOPLE WERE SEEING THAT, THAT'S WHAT THEY SEE IN OUR MEDIA, THEN, OF COURSE, THEY'RE GOING TO BE AFRAID OR NERVOUS.

BUT WHAT WE DO KNOW ABOUT STIGMA, ONE OF THE MOST IMPORTANT THINGS TO COMBAT THAT IS INDIVIDUALS THAT KNOW SOMEONE THAT HAS A MENTAL ILLNESS OR WHO HAS REGULAR CONTACT WITH SOMEONE THAT HAS A MENTAL ILLNESS IS THE SINGLE MOST EFFECTIVE WAY TO REDUCE STIGMA.

AND THE ONLY WAY FOR US TO DO THAT IS TO SHARE OUR STORIES.

SO SHARE OUR STORIES WHERE MAYBE WE WERE DEPRESSED OR WE WENT THROUGH A DEPRESSION OR WE HAVE A LOVED ONE WHO IS GOING THROUGH SOME OF THAT.

IT CAN BE VERY NORMALIZING TO PEOPLE AND REALLY SORT OF AGAIN ADDRESS THE STIGMA THAT IS OFTEN TIMES ASSOCIATED WITH MENTAL ILLNESS.

>> SO WE HAVE PEOPLE WHO HAVE A MENTAL ILLNESS.

BUT DO WE HAVE PEOPLE TO TAKE CARE OF THOSE PATIENTS?

>> YES AND NO.

WE ARE-- THE WORKFORCE IS IMPROVING BUTS WE ARE, IN KENTUCKY, IN A SHORTAGE AREA FOR MENTAL HEALTH PROVIDERS.

WE NEED ABOUT 200 MORE PROVIDERS TO MEET THE NEEDS OF OUR POPULATION.

AND WE ALSO KNOW THAT MANY TIMES PEOPLE DON'T GET THE CARE THEY NEED BECAUSE OF THE COST ASSOCIATED WITH THAT.

ONE INTERESTING STATISTIC IS THAT IN KENTUCKY, INDIVIDUALS ARE THREE TIMES MORE LIKELY TO BE OUT OF NETWORK FOR A MENTAL HEALTH PROVIDER THAN THEY ARE A PRIMARY CARE PROVIDER.

SO ACCESS CAN BECOME AN ISSUE BECAUSE THEY'RE OUT OF NETWORK FOR THAT SERVICE AND IT'S A MORE EXPENSIVE-- >> WHAT ABOUT RURAL AREAS?

I IMAGINE IS THIS SOMETHING WE FIND THE PROFESSIONALS IN THE URBAN AREAS OR RURAL AREAS WE ARE NOT DOING SO WELL?

>> I THINK TO LIPPED LINDSEY'S POINT, WE HAVE MADE SIGNIFICANT IMPROVEMENTS.

TELEHEALTH HAS HELPED US EXPAND THE REACH OF OUR PROVIDERS.

>> TELL ME ABOUT THAT.

>> THE ABILITY TO PICK UP YOUR PHONE AND IN PUTT LASKEY COUNTY AND BE-- PULASKI COUNTY AND HAVE A THERAPIST IN LEXINGTON.

WE HAVE HAD SIGNIFICANT IMPROVEMENTS AND ADVANCES IN THAT PARTICULAR AREA.

BUT STILL YET IT'S NOT ALWAYS ENOUGH.

AS LINDSEY SAID EARLIER, WE HAVE HAD IMPROVEMENTS PARTICULARLY AROUND SUBSTANCE USE, WE HAVE HAD PROVIDERS COMING INTO THE STATE TO HELP WITH THAT.

BUT THERE IS STILL SO MUCH NEED FOR PROVIDERS, MENTAL HEALTH PROVIDERS.

TAKE ME THROUGH AN ACUTE CRISIS.

WHAT DOES THAT LOOK LIKE.

HOW DOES EMPATH FIT IN.

>> IT CAN LOOK DIFFERENT FOR EVERYONE.

FOR SOME IT MIGHT BE SUBSTANCE USE ESCALATION OF USE.

MAYBE NOT GOING TO WORK, NOT FULFILLING THEIR DAILY RESPONSIBILITIES.

IT MIGHT BE A SUICIDAL CRISIS.

SO SOMEONE WHO IS EXPERIENCE EXPERIENCING THOUGHTS OF WANTING TO HARM THEMSELVES, THINKING THEY CAN'T GO ON, FEELING HOPELESS.

IT COULD BE PSYCHOSIS.

DIFFERENT PERCEPTIONS OF REALITY IT COULD BE ANY OF THOSE THINGS.

AND WITH EMPATH, WE'VE REALLY DESIGNED A PROGRAM THAT IS AVAILABLE 24/7, 365 DAYS A WE ARE BECAUSE WE CAN'T DEFINE WHEN SOMEONE'S CRISIS IS GOING TO HAPPEN.

BUT BECAUSE OF THAT, WE CAN ADDRESS THE CONCERNS AND THAT PERSON DEFINES THE CRISIS.

IT'S NOT THAT YOU ARE NOT SICK ENOUGH OR TOO SICK.

RIGHTS A WIDE NET AND WE CAN SERVE ANYONE WHO HAS A CRISIS THAT FEELS THEY NEED ADDITIONAL SUPPORT.

>> SO IS THIS A PHYSICAL THING OR LIKE YOU TALKED ABOUT, TELEHEALTH?

>> IT'S A PHYSICAL THING.

SO IT'S AN ALTERNATIVE TO THE E.D.s, A MODEL THAT ORIGINATED IN CALIFORNIA.

THERE IS ABOUT 30 OF THESE EMPATH CENTERS ACROSS THE COUNTRY AND WE ARE THE FIRST IN KENTUCKY.

AND AS LINDSEY SAID, IT'S DESIGNED TO BE OPEN 24 HOURS A DAY, SEVEN DAYS A WEEK, LOW BARRIER, MEANING YOU DON'T HAVE TO CALL AND GET AN APPOINTMENT OR WHATEVER, YOU JUST DRIVE UP, SHOW UP AND WITHIN 30 MINUTES YOU ARE IN FRONT OF A PROVIDER WHO IS SITTING DOWN TRYING TO PROVIDE A PLAN OF DARE WITH YOU.

>> WHY WOULDN'T I GO TO THE EMERGENCY ROOM FOR IN THE HOSPITAL?

>> EMERGENCY ROOMS DO AMAZING GROUP AND WE ARE THANKFUL-FOR-THEM BUT WHEN YOU HAVE A MENTAL HEALTH CRISIS AND SHOW UP AT THE ED, OFTEN TIMES YOU ARE PRIORITIZED DOWN THE LIST.

YOU ARE BEHIND A MOTOR VEHICLE ACCIDENT OR A HEART ATTACK.

UNDERSTANDABLY SO.

YOU MAY BE PLACED IN THE BACK OF THE ROOM AND WHEN YOU ARE EXPERIENCING A CRISIS, AND YOU ARE HEARING ALL THESE LOUD NOISES AND YOU ARE FORCED TO CHANGE INTO A GOWN AND YOU MAY BE GIVEN A SITTER, SOMEBODY WHO HAS TO SIT WITH YOU 24 HOURS A DAY AND A LOT OF THAT PRIVACY SORT OF TAKEN AWAY FROM YOU AND THAT AGENCY IS TAKEN AWAY FROM YOU.

RATHER THE EMPATH CENTER IS A LOT OF THE OPPOSITE OF THOSE THINGS.

SO OUT OF THE GATE YOU ARE GOING TO BE GREETED IN A TIMELY MANNER AND YOU ARE GOING TO BE THE PRIORITY.

YOU ARE GOING TO BE GREETED WITH BEHAVIORAL HEALTH SPECIALISTS AND EXPERTS WHO ARE THERE WANTING TO MAKE YOU COMFORTABLE AND UNDERSTAND WHY YOU ARE THERE AND MEET YOUR NEEDS.

>> WHAT ABOUT THE PERSON WHO GETS PICKED UP TAKEN TO JAIL.

WILL A JAIL CONTACT YOU ALSO?

>> WE HAVE WORKED WITH THE COMMUNITY PARTNERS, OUR POLICE, LOCAL FIRE DEPARTMENT, EMS SERVICE, SO THAT THOSE PEOPLE DON'T GET TO JAIL.

WE WORK WITH THEM TO SAY IF THEY'RE IN A MENTAL HEALTH CRISIS, WE WANT TO YOU BRING THEM DIRECTLY TO US SO THEY DON'T HAVE TO GO TO THE EMERGENCY DEPARTMENT FIRST.

THEY CAN COME DIRECTLY TO US AND WE HAVE A SPACE FOR OUR COMMUNITY PARTNERS TO DROP FOLKS OFF AND DMEET THEIR PAPERWORK AND WE TAKE ON THAT INDIVIDUAL'S CARE.

WE WORK WITH THAT PATIENT.

WE HAVE TRIED TO MAKE IT SIMPLE AND EASY AND THIS IS THE DESTINATION FOR WHERE WE DO BEHAVIORAL HEALTHCARE.

>> SO YOU TAKE THE PATIENT IN AND YOU START ALL THESE SERVICES.

DOES THAT MEAN YOU ARE STARTING TREATMENT ALSO?

>> ABSOLUTELY.

>> WHAT DOES THAT TREATMENT LOOK LIKE?

>> IT CAN LOOK DIFFERENT FOR EVERYONE.

IT CAN BE MEDICATIONS.

MANY TIMES IT'S THURP THERAPEUTIC INTERACTIONS AND PEER SUPPORT.

THEY HAVE BEEN THROUGH THESE THINGS.

WHAT THEY BRING IS HOPE.

HOPE IS A MAJOR ACT DOTE TO DEPRESSION.

SO ALL OF THESE SERVICES, THE IDEA IS THAT WE ARE NOT JUST EVALUATING SOMEONE TO SAY YOU ARE GOING INPATIENT OR YOU ARE GOING TO THESE OUTPATIENT SERVICES.

WE ARE TREATING THAT PERSON FOR UP TO 23 HOURS.

ON AVERAGE PEOPLE ARE WITH US UP TO 15 HOURS AND ALL 15 HOURS ARE ACTIVE TREATMENT SO WE START MEDICATION AS SOON AS SOMEONE COMES IN THE DOOR IF THAT'S WHAT IS NEEDED AND THAT'S WHAT THEY WANT.

WE ARE NOT GOING TO REQUIRE THAT SOMEONE HAVE ANY PARTICULAR PLAN OF CARE.

WE ARE GOING TO DEVELOP THAT WITH THEM.

AND THEY'RE MEETING WITH MENTAL HEALTH PROFESSIONALS WHO CAN PROVIDE THERAPEUTIC SERVICES; A SOCIAL WORKER WHO CAN SAY WHAT NEEDS DO YOU HAVE?

HOW CAN WE CONNECT YOU TO RESOURCES FOR FOOD IF THAT'S A MAJOR ISSUE OR OUTPATIENT SERVICES TO CONTINUE ON YOUR CARE.

>> AND SHE SAID SOMETHING, TOO, THE AMOUNT OF TIME.

THE AMOUNT OF TIME I THINK THAT SOMEBODY SPENDS IN THE ED, YOU HEAR ALL THESE STORIES, SOMETIMES OF BEHAVIORAL HEALTH PATIENT IN THERE FOR SEVERAL DAYS AND RECEIVING VERY LITTLE SERVICES.

AND THE 15 HOURS OR LESS SOMETIMES, RIGHT?

THAT THEY WOULD BE WITH US THEY'RE GETTING CONSTANT TREATMENT.

AND I CAN'T SAY ENOUGH ABOUT THE ACTUAL ENVIRONMENT ITSELF AND HOW THERAPEUTIC THE ENVIRONMENT IS.

THEY HAVE THE ABILITY, WHEN THEY'RE IN AN E.D., THEY'RE IN THEIR CUBBY HOLE OR IN A HALLWAY, RIGHT, BUT ON EMPATH, THEY HAVE-- THEY'RE GIVEN A CHAIR, ASSIGNED A VERY COMFORTABLE CHAIR THAT IS ABLE TO RECLINE FULLY SO THEY CAN SLEEP IN THIS CHAIR.

THEY'RE ABLE TO MOVE THIS CHAIR TO THE POSITION ON THE UNIT THAT THEY WANT TO BE IN.

WE HAVE OPEN SNACKS AND FOOD THAT THEY CAN GO AND JUST WITH THEIR OWN AGENCY, GO UP AND CHOOSE HOW MUCH TO GET AND HOW MUCH TO DRINK.

SO IT'S A VERY OPEN, WARM, WELCOMING SORT OF ENVIRONMENT VERSUS SOMETIMES THE E.D.

CAN GET LOUD AND IT CAN BE BOISTEROUS.

>> HOW MUCH CAN YOU ACCOMPLISH IN 15 HOURS OR 23 HOUR TIME.

TO ME THAT SEEMS LIKE AN INORDINATELY SHORT PERIOD OF TIME FOR A CHRONIC ILLNESS.

THAT'S WHAT I'M TRYING TO FIGURE OUT.

WHAT IS IT THAT YOU ARE DOING HERE?

3.

>> SO MUCH LIKE AN E.D., WE ARE STABILIZING THE CRISIS, RIGHT?

AND SO WE ARE STABILIZING AN THEN CONNECTING TO SERVICESES IN THE COMMUNITY.

WE DO A REMARKABLE AMOUNT OF WORK IN 15 HOURS WITH SOMEONE, AND ONLY ABOUT OF THOSE WHO COME TO EMPATH, ONLY 25% OF PEOPLE REQUIRE HOSPITALIZATION BEYOND THAT.

SO WE CAN STABILIZE AROUND 70 TO 75% OF THOSE FOLKS AND THEN CONNECT THEM TO OUTPATIENT SERVICES.

>> WHO ARE THESE OUTPATIENT SERVICES AND ARE THEY WILLING TO TAKE A PERSON IN?

I IMAGINE YOU DON'T WANT SOMEONE SAYING YOU WANT YOU TO GO SEE Dr. WOODS BUT YOU CAN'T SEE HIM FOR ANOTHER FOUR WEEKS.

>> NOT LIKE THAT.

SO WE ARE ACTIVELY WORKING WITH NEW VISTA, OUR COMMUNITY MENTAL HEALTH CENTER, THAT FOR A LOT OF OUR OUTPATIENT SORT OF APPOINTMENTS AND THEY'RE ABLE TO SEE PEOPLE WITHIN 24 TO 48 HOURS.

WHAT WE KNOW IS THAT AT EASTERN STATE HOSPITAL, WHEN SOMEONE HAD BEEN THERE FOR SEVERAL, YOU KNOW, MAYBE A WEEKS OR MONTHS, WE WOULD GET THEM A FOLLOW-UP APPOINTMENT, THAT RATE WAS SOMETHING LIKE A 29% FOLLOW-UP RATE AFTER THEY WERE DISCHARGED BUT WHAT WE ARE SEEING AT EMPATH-- YEAH, THAT'S LOW.

WHAT WE ARE SEEING AT EMPATH IS THAT IT IS NEARLY DOUBLE.

SOMEBODY COMES TO EMPATH, THEY'RE GETTING AN APPOINTMENT WITHIN 24 TO 48 HOURS LATER AND ABOUT 60% OF THOSE-- AND THERE HAVE BEEN SOME MONTHS UP TO 70%, ARE SHOWING UP FOR THAT APPOINTMENT.

IT'S SUPER, SUPER IMPORTANT.

THE OTHER PIECE I WOULD POINT OUT IS THAT WHEN SOMEONE WITH A SUBSTANCE USE DISORDER GOES FOR HELP AT AN E.D., THEIR CRISIS WILL OFTEN TIMES BEING, AND LINDSEY DESCRIBED IS STABILIZED FOR SURE, BUT WHAT DOESN'T HAPPEN IS THAT THAT CONNECTION TO NEXT SERVICES OR FOLLOW-UP.

AND SO THE THING THAT EMPATH WE ARE SUPER PROUD OF THIS, WE HAVE BEEN ABLE TO DO FOR PATIENTS LIKE THAT IS GET THEM CONNECTED TO RESIDENTIAL TREATMENT.

SO THEY LEAVE OUR ORGANIZATION AND WE TAKE OUR TRANSPORTATION AND DRIVE THEM OVER TO THIS RESIDENTIAL TREATMENT WHERE THEY CONTINUE THAT TREATMENT THAT THEY NEED.

AND SO THAT'S A UNIQUE DYNAMIC THAT, IT CAN HAPPEN IN AN E.D.

BUT OFTEN TIMES DOES NOT HAPPEN IN AN E.D.

>> I APOLOGIZE BUT HAVE I TO ASK THIS QUESTION.

WHO IS PAYING FOR THIS?

>> IT'S BASED ON THE REVENUE THAT WE GET FROM INSURANCE COMPANIES AND THINGS LIKE THAT.

WE DO HAVE SOME FOLKS WHO COME IN THAT DON'T HAVE INSURANCE AND WE WORK WITH THEM ON A PAYMENT PLAN.

>> SOME INSURANCE PLANS WILL COVER.

>> YES.

>> SO THIS IS NOT A-- NOTHING IN HEALTHCARE IS FREE I GUESS ANYMORE, BUT THIS IS A SERVICER THOUGH THAT IS BILLED AND... >> THIS IS A MORE ECONOMICAL CHOICE THAN AN E.D.

WE DO A LOT OF TRANSPORTATION BACK TO THEIR HOMES.

WE TRANSPORT THEM BACK HOME.

THERE IS NOT AN EMS OR AN AMBULANCE SORT OF TRANSPORT CHARGE FOR THAT BUT THIS IS A MORE ECONOMICAL CHOICE FOR OUR PATIENTS.

>> AND WHERE IS EMPATH LOCATED?

WHAT IS THE LOCATION?

>> ON THE CAMPUS OF EASTERN STATE HOSPITAL, A SEPARATE ENTRANCE BUT IT IS ON THAT CAMPUS.

>> YOU ARE THERE BUT YOU ARE NOT THERE.

CAN I DRIVE UP MYSELF OR DRIVE FAMILY MEMBER OR FRIEND UP THERE AND SAY HEY, THIS IS WHAT THEY'RE DOING AND YOU GUYS WILL TAKE OVER AND TAKE A LOOK.

>> WHATEVER YOU WANT.

1:00 IN THE MORNING, FRIDAYS, HOLIDAYS, WHENEVER YOU WANT IT, ABSOLUTELY.

>> DAYTIME, NIGHT TIME, SATURDAYS TOO, THE DOOR IS ALWAYS OPEN.

>> ABSOLUTELY.

>> THAT'S AMAZING.

THE IDEA MOST IMPORTANT IS HOW YOU CAN GET FOLKS INTO RESIDENTIAL CARE OR TO SEEING SOMEONE ON AN OUTPATIENT BASIS.

>> ABSOLUTELY.

WE HAVE BEEN DOING THAT-- AND WE WORK WITH OTHER ORGANIZATIONS AS WELL, NEW VISTA IS ONE.

CERTAINLY THE RIDGE.

WE WORK WITH THE RIDGE.

A LOT OF THIS IS ABOUT GIVING CHOICE TO THE PATIENT WHERE THEY WANT TO CONTINUE THEIR SERVICE.

>> THAT'S FANTASTIC.

I WANT TO THANK YOU BOTH FOR BEING WITH US.

DISCUSSING SOMETHING TOO MANY OF US DON'T WANT TO TALK ABOUT AND YOU DID ADDRESS THAT.

I WOULD LIKE TO THANK YOU FOR BEING WITH US TODAY.

I HOPE YOU NOW HAVE A BETTER UNDERSTANDING OF THE NEED FOR SPECIALIZED ACUTE MENTAL HEALTH CARE AND WHERE YOU CAN FIND IT.

THERE ARE OPTIONS.

AND IF YOU OR A FRIEND OR A FAMILY MEMBER NEEDS TREATMENT, PLEASE SEEK IT AS QUICKLY AS POSSIBLE.

IF YOU WISH TO WATCH THIS SHOW AGAIN OR WATCH AN ARCHIVED VERSION OF PAST SHOWS GO TO ket.org/HEALTH.

IF YOU HAVE A QUESTION ABOUT THIS OR OTHER SHOWS, WE CAN BE REACHED AT ket.org.

KENTUCKYHEALTH@ket.org.

I LOOK FORWARD TO SEEING YOU ON THE NEXT "KENTUCKY HEALTH."

IF YOU HAVE CONCERNS OR QUESTIONS ABOUT MENTAL HEALTH ISSUES, TALK TO YOUR PRIMARY CARE PROVIDER OR THE GOOD FOLKS AT EMPATH AND GET GOOD CARE.

THANK YOU VERY MUCH.

>> "KENTUCKY HEALTH" IS FUNDED IN PART BY A GRANT FROM THE FOUNDATION FOR A HEALTHY KENTUCKY.