August 20, 2025 • 29 mins
Carly sits down with two professionals from EmPATH - a facility that personally helped her during crisis. EmPATH is Minnesota’s FIRST emergency mental health unit. Learn more about this groundbreaking resource and Carly’s experience at EmPATH.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Welcome to the second episode of season two of Here
we Go. Today is a very feels like emotional and
special day for me on this session because I am
almost at two and a half years sober and two
and a half years since I went into the place
(00:21):
that saved my life, and that place is m Path
right here in the Twin Cities in the Dinah area,
And milestones are big in the world of recovery, and
so two and a half years sober is a really
big deal to me. If you would have told me
that four years ago that I'd have a week sober,
(00:43):
I would have laughed in your face. So to have
this milestone is really big to me. And then to
share it with two people from MPATH who help build
this program and keep it going, it's a really special day.
So I'm excited to have two guests on Here we
Go Today, and this is Michelle Snyder. She's a system
(01:05):
director of mental health and Addiction and Clinical Services over
at m Health Fairviews MPATH and Rich Levine, medical director
of Behavioral Outpatient Services.
Speaker 2 (01:17):
Welcome to Here we Go US. Yeah, and you guys
can sneak close to those mics and sounds good. Get
up in there.
Speaker 1 (01:29):
First, I want to say thank you to both of you,
because as I've been doing this podcast, I've tried to
thank people along the way because it is a village.
It's a massive amount of people who do help you
to get into recovery and to get you to the
place you need to be. And I didn't even know
who you were, but the impact you've had with what
(01:54):
you've created with MPATH saved my life. And so I
just wanted to say thank you to both of you.
Speaker 3 (02:02):
You're welcome. We would also like to thank you taking
that leap of faith of stepping in and having somebody
take your life in your hands and help you through.
That's what we love to do, and it's very scary
for a lot of people to come in and so
we really appreciate when people come in and say I'm
(02:22):
here for help, and that's when we can do what
we can do.
Speaker 1 (02:25):
It was it's funny you say that, Bege use that
word because February fifth, twenty twenty three, I say.
Speaker 2 (02:32):
Is probably the scariest day of my life.
Speaker 1 (02:35):
And people are like, you were scared, you know, not
depressed or sad or other things, And I say, I
just kept saying I'm so scared. I'm so afraid leading
up to that day, even but it.
Speaker 2 (02:49):
Was probably the scariest day. Do you guys hear that
from people a lot?
Speaker 4 (02:53):
We do. You're really confronting yourself and your trauma and
your crisis, and people push it off often for as
long as they can and get to a point where
the fear of changing is finally not the worst. It's like, no,
now I'm ready and now I need it.
Speaker 2 (03:09):
Can we talk about the basic of mpaths.
Speaker 1 (03:11):
So if somebody is listening to this for the very
first time, I mean, I've.
Speaker 2 (03:14):
Talked about it a ton, but mpath.
Speaker 1 (03:18):
Itself, would one of you guys just talk about what
it is and why it was created?
Speaker 4 (03:25):
Yeah?
Speaker 3 (03:26):
So Rich, go ahead, Okay. So the EmPATH was designed
in a particular way to help somebody in a mental
health crisis in an emergency room. And we know the
emergency room is a wonderful place and they do wonderful
work in saving lives and stabilizing people to get them
(03:48):
to the next stage of whatever treatment it is. But
emergency rooms were not built for mental health crisis. They
are loud, they're noisy, they're busy, they move fast. There
are unsafe things in rooms, you have to stay in
your room, you're not allowed to move around because you
don't want to be walking into another room or a
(04:10):
busy nurse who's doing something, or another physician. So it's
not made for mental health crisis. And the EmPATH said,
wait a minute, we need to relook at what we're doing.
How do we help And we already talked about that
fear of coming in in a mental health crisis. When
you have chest pain, you're scared, but you know exactly
(04:30):
where you're supposed to go. When you're in a mental
health crisis, or you're feeling souicidal, or you're not sure
what's real or not real, you don't know where to
go and so you're extremely scared. And so we needed
to build something that could take somebody coming into a
crisis and help them start to relax, de escalate that
(04:51):
and think about it. And so we built this EmPATH
very purposeful of how do we take somebody out of
that busy emergency room, have space, have agency of people
being able to get up and move around, get something
to eat, get a warm blanket, be able to go
to the restroom when they want to. And then of
course the trained professional mental health staff to be able
(05:13):
to look at this, and I'll let Michelle talk about
all our different pieces of that. But we want to
be able to start medications and we want to start
therapy right away, try to de escalate, and then when
things are in a better light at that moment, we're
able to start making a plan for how are we
going to continue the momentum we started here in the EmPATH.
Speaker 1 (05:32):
There's so many things during this podcast. I hope somebody
listening might learn, first, if you're in crisis, an opportunity
for a place to go. Second, things that I didn't
know when I stepped foot inside those walls that I've
learned along the way that are very beneficial to getting help.
Speaker 2 (05:53):
One of them being.
Speaker 1 (05:54):
How dangerous it is to come off of alcohol and
you don't I mean, yeah, you get a hang people
think you get a hangover, but it is correct. I
think the only substance you can die from almost coming
off of they say one, I mean one of the
most danger yeah yeah, And so I think again these
(06:19):
places mpath is a great place to get help in
a way that will make sure you're safely doing it.
And so do you want to talk about some of
those pieces that, right, you're talking about.
Speaker 4 (06:30):
Well, one of the things that makes EmPATH really special
is that it's a multidisciplinary approach, right, So we're coming
at the crisis from at least three different areas. There's
a medication component and a physical safety and health component,
which you experienced in you know, getting those medical needs met.
(06:51):
There is a review for medication. Psychiatry is a big
driver of the health that you're going to get an EmPATH,
But like Rich mentioned too, there's also a therapeutic component.
There's licensed therapists who are there around the clock to
make the plan of care to help progress you through.
And then we have a whole nursing team who is
there to really drive those nursing cares and provide the
(07:13):
structure and support for the entire environment and make sure
that everybody is getting what has been ordered by the
providers and what they need to be safe. As we
calm everything down and put together a plan for how
to move forward on the road to safety or recovery.
Speaker 2 (07:32):
It's interesting.
Speaker 1 (07:33):
Okay, so I've never told this on air, but when
I went to MPATH, the people I worked with, I
first want to say, we're so empathetic which just fits
kind and you feel already so much shame, and usually
if you're in that state, you're already being so hard
(07:55):
on yourself to feel shame going in there or in embarrassed.
I had so much embarrassment going in there, And when
I was sitting in one of the first rooms, the
guy with me said, hey, like, you know, it just
felt like he knew who I was. Like he must
(08:15):
listen to power Trip or something, and he's like, I
just want you to know your privacy here is of
our utmost importance. He's like, you do not have to
worry about somebody releasing your information saying that you're here.
Speaker 2 (08:32):
And so he did say he.
Speaker 1 (08:34):
Knew who I was and he just wanted to know
that he wanted me to know my privacy was so important.
And he's like, that's not just for you, that's for everybody.
And so I thought the way that they engage with
the people there too, is really thoughtful. And I don't
(08:55):
know how you guys hire, but what a great job
to do that. And I think that's another thing for
people that may be looking for this help is I'm
so embarrassed, I feel so much shame that I need
this or that you know, I'm an adult, I should
have this figured out. And I would say that you
(09:15):
guys would probably agree like don't feel that going in right,
or like try to take that away.
Speaker 4 (09:22):
Well, and I think it's really hard to say don't
feel that. People are going to feel that. What I
think you want to do is ask some questions, Hey,
do you have rules about this? What is the plan?
And really get that information. Our goal is to provide
the most person centered experience because everyone's needs are going
to be a little bit different. A lot of the
(09:43):
problems are going to be the same, but how it's
experienced in the context that people live in is going
to be different. So things are going to be really
important to you. Bring them up and ask the questions,
have a conversation about it so that you can get
that reassurance.
Speaker 1 (09:57):
And I question about you don't necessarily have to be
use substance abuse to go in right, it's more based
on a mental health crisis, correct.
Speaker 4 (10:09):
Right, And they come in all different shapes.
Speaker 1 (10:12):
Okay, yeah, yeah, And so I think that's super important
to know because if you're listening, you're like, well, I'm
you know, I don't use anything, but I'm struggling. It's
still a great place to go. And one of the
things that helped me the most was bridging from this
crisis center to where I was going to go next,
because you can stay at MPATH. I stayed there for
(10:35):
almost three days because they had found me a place
to go, and I wanted to go what's called door
to door, so I wanted to go straight from MPATH
to a treatment facility, so they allowed me to stay.
I think they said the average stay is about two days.
Speaker 3 (10:51):
It's actually about twenty four hours.
Speaker 2 (10:53):
Really, Oh my gosh, you guys are good.
Speaker 1 (10:57):
But what I thought I want to want to talk
about is bridging the gap between your crisis stay there
and then going somewhere else. And how important that is
because if I would have gone home, I would have
probably just gone right back into the cycle.
Speaker 3 (11:13):
Yeah, it's one of our major factors of how the
EmPATH works and why we get such good results. I've
been doing emergency room care for twenty years in the
mental health field, and previous we would give resources, we
may even be able to give some appointments, we may
be able to give some medications, but ultimately we're just
(11:33):
saying we saw you for a couple hours. This is
what we're doing. Good luck, and what the MPATH is
able to do is give us some more time, be
able to make sure that the treatment plan that we're
going to do to send you home with is the
right treatment plan and that we're actually able to set
it up and do what we would like to do.
(11:54):
And sometimes that can happen in a couple hours. Sometimes
that takes three days. And we have the flexible ability.
We certainly it's not an impatient unit. We don't want
people staying there for a week. We would move you
on to an impatient unit if something was that severe.
But if we have that ability to bridge the gap
as you talked about and make sure that we have
the right discharge work, then we know we're going to
(12:18):
be successful and the patient's going to be successful. One
of the things that we measure when we look at
is not just how well are we getting people to
the right placement and discharging, but do they come back?
And so one of our things is and people talk about,
you've decreased the number of people that have to go
to impatient unit, so you must be just discharging and
(12:41):
fascin they must just come back to the emergency room,
and that's not the case. And in fact, wonder about
twenty percent of people coming back within thirty days to
maybe be fifteen for thirty days, fifteen percent for thirty
days of returning, which means we are setting up the
right outpatient, We are getting them the right plans so
they can't continue to take again the momentum that they
(13:03):
started in that EmPATH.
Speaker 4 (13:04):
Yeah, time to plan that transition is really important. And
that is one of the features and the gifts of
an EmPATH unit is that it's it's not quite as
rushed as an emergency department is Michelle.
Speaker 2 (13:18):
You mentioned it too.
Speaker 1 (13:21):
The tailoring of each person too, and the ability you
guys have to do that because.
Speaker 2 (13:27):
Maybe you need an outpatient.
Speaker 1 (13:28):
You know, there's so many options when it comes to treatment,
and tailoring it for people I think is so crucial.
What I want to go into just a very basic
thing quickly. So if let's say I'm let's say I'm
sitting at home and I am having suicidal ideation, I
(13:48):
am in a crisis situation, what would be your first
step with that path?
Speaker 4 (13:55):
So the first thing I would want people to kind
of think and is to reach out to some get
somebody on the phone, tell a family member that's in
the house, you know, let somebody else know, so that
you have some company while you're making that next decision.
That's really important is to have company. Wouldn't you say?
Speaker 1 (14:13):
My sister and my best girlfriends were the ones sitting
right next to me when we made the call, and
so it's exactly what you said.
Speaker 2 (14:20):
That's that's that safe.
Speaker 4 (14:21):
It was the best thing, right someone to kind of
encourage you, but also just to be there and to
decide if we have time to make a decision about
where to go, or do we need to call nine
one one and get help right this second, because it's
going to make a difference if EmPATH is is you know,
you've heard about it before, you're thinking that might be
(14:41):
a good thing for me. What you want to do
is start at the emergency department. That is that is
the place to start, which is over at Southdale.
Speaker 3 (14:50):
Yeah, just so people know that everybody would go through
the emergency room before you get to the EmPATH, and
we do that very purposely. We want to make make
sure that there isn't a medical issue going on that
we need to deal with first. A lot of mental
health will have some true medical issue that may be
either the cause or because of the mental health. There's
(15:12):
something else going on that we need to acutely take
care of medically before we start doing some of the
work that we do. And so everybody gets in, gets
that triage done. If everything is okay, then we bring
them over to the EmPATH as quick as we can.
Speaker 1 (15:26):
One of the things we've been talking about, all the
wonderful things, and we will continue to do so. But
it's really unfortunate. I think how few and far between
there are of these units, of these places to go,
not just I don't know if they're all called mpath.
You guys can let me know, but I think you
(15:47):
guys said earlier there were about fifty of them.
Speaker 2 (15:50):
Across the country.
Speaker 1 (15:51):
We know that our mental health crisis is much bigger
than that, and so what are the challenges with building
more of them? Why don't we see more of them?
You know, because on the outside it's like, well, why.
Speaker 2 (16:03):
Don't we have more of these? Like let's put them everywhere?
But talk about, as two people so.
Speaker 1 (16:08):
Heavily involved, what the challenges are with creating them and
sustaining them.
Speaker 4 (16:13):
Well, first I would want to make sure that we
share that every emergency department can assess and get you
to some safety and get some of these things going.
So EmPATH is just going to be a little bit
different because it's built and focused differently.
Speaker 1 (16:28):
And so yeah, we're not discouraging you from going into
the ear. We're saying this option is such a tremendous
I mean, this is such an option to.
Speaker 4 (16:36):
Have, and it's new, and it is, like you said,
emerging across the country, but I think internationally too, So
it really is sort of a spreading idea as we
in the industry recognize the benefits and how good it
is for the people who have a chance to go through.
Speaker 3 (16:54):
For the most part, I can take just a short
story on the side from that. We had a resident
from Scotland who really was interested in doing better mental
health care in their emergency rooms and obviously their medical
system is drastically different than ours, and so she reached
out and she came over for a month and a
half and worked in the MPATH with us and has
(17:17):
gone back to Scotland has been able to get one
set up in Scotland in Glasgow, not Glasgow, Edinburgh, Edinburgh,
thank you. And so these are the kind of things
that is really great about espousing the MPATH model in
(17:38):
it again, it's new. Anytime we start with something new
or different, the payments have to catch up. And this
is the hard part with the MPATH. A lot of
the work that we do is something that isn't to build.
Speaker 2 (17:54):
And yeah, insurance you're talking about.
Speaker 3 (17:57):
With traditional insurance companies, Medicare, Medicaid, they don't pay for
the time and the work to do the discharge plan
that we've already talked about that really helps set somebody up.
They'll pay for the crisis assessment that the therapist might do,
they'll pay for the visit that the psychiatrist might do.
But in the MPATH we do a lot more than
(18:18):
just that. We do some second touch points. We work
on making phone calls to try to get things set
up that doesn't get paid for. So what makes the
er helpful is they get people in and out really quickly.
One of the things that's great about the EmPATH is
we have time. But because we have that time, we
don't get as many people through as we would like
to because each person somebody may needs two hours and
(18:40):
somebody needs three days, and we want to make sure
that we meet each person where they're at.
Speaker 1 (18:46):
If do you, I don't know if you guys pread
answer this question or not. I'm sure you have your
own opinions on it, but if you don't feel comfortable,
let me know. But I talk a lot about the
connection between mental health and addiction and the mental health
and substance use and what I again, another great thing
about EmPATH and what you guys are doing and what
(19:06):
you're promoting for me. It ties the two together. You
don't just go in and get medication to be okay
and then leave.
Speaker 2 (19:14):
It's we have therapists, we have.
Speaker 1 (19:16):
You know, the ability to connect you with treatments, all
sorts of things that help. What are your beliefs or
what have you seen change in the years you've been
in work, because I do feel like it's relatively new
that we're saying these two things are always I would
I would, I would argue, and people can disagree. Tied together.
I think that they are always tied together. And so
(19:38):
I don't know if either of you have any experience
or something you wanted to add to that.
Speaker 3 (19:45):
Absolutely, Traditionally there was a belief and specifically for addiction
issue substance use issues that you would need to get
clean of the suf since and sober before we would
start to treat mental health. And we have learned over
(20:09):
the last twenty twenty five years that there isn't a
separation of that and we need to treat both at
the same time. Now we know if we don't treat
the depression, it's going to be really hard for the
alcohol use disorder to get treated, and vice versa. If
we don't treat the alcohol use disorder, your depression is
(20:29):
going to be really hard to treat. Because we're combating
those two things, it goes even a step further. We're
really starting to learn a lot more about just integrating
mental health into primary care, and we call it collaborative
care where we really work hard for our primary care
(20:49):
docs to have therapists and availability for psychiatrists because we
know we get better medical outcomes for diabetes like blood
pressure if we treat depression and we treat anxiety, and
so it's taking a step beyond even what you're describing
that it's a whole mind body connection. There's no doubt
(21:10):
with that, and it's partly what the MPATH worked so
well on it. And I'm curious for you if you
remember one team member a little bit more than another,
because we look at it as a team game. It's
not the medical provider, it's not the er doc, it's
(21:30):
not the nurse, it's not the therapist, it's all of
us together, the coordinator who comes out and gives you
your appointment information. We look at as all of us
are taking care of you. But I'm curious as somebody
going through if you thought, oh, there was one person
who was more involved, or if you actually thought I
had a bunch of people involved.
Speaker 2 (21:50):
I truly mean this.
Speaker 1 (21:51):
It felt like every interaction I had from the moment.
So I moved pretty quickly through the er and I'm
sure they try to do that on perper And then
you first have to go back and it feels a
little bit like going to jail, maybe like you know,
things are you have to give up your phone, you
shoelaces are taken out, and it's it's purposeful, there's a reason,
(22:12):
but it feels a little bit.
Speaker 2 (22:13):
It can be again scary.
Speaker 1 (22:15):
And the woman who helped me through that, and then
the woman who got me, I don't know if she
would have been a nurse or just hert nurse, but
who started taking my vitals and taking you know, I
sat in a chair there. It's where I stayed most
of the time. It was their kindness absolutely, not only
(22:37):
their education, like they knew what they were doing, but
it was their kindness and gentle ability to help me.
That was that was so excellent for me. That felt
like such a great experience because I needed that in
that moment, I had just spent thirty eight years beating
(22:59):
myself down and and I had just been in the
worst part of my addiction i'd been in, you know,
and it was so I needed that that gentleness and
that kindness way more than I thought I did. So
even when it was going up to the desk there
and asking for something, it was not like a it
(23:22):
was like a yes, of course you can. It was
just like a gentle And I say gentle because it
was so. It was just that it was done in
such a kind way and a soft way that made
me feel safe. And that's what I think I was
looking that it made me feel safe, and I needed
(23:44):
to feel safe, and I hadn't felt safe.
Speaker 2 (23:47):
In a long time.
Speaker 1 (23:49):
And then the coordinator or two I remember feeling very
heard because I kept saying, I need somewhere that will
treat my mental health. I kept saying that, like I know,
I'm not okay, and I need somewhere that will help
with my mental health. And so there are many places
you can go for treatment, but she said to me,
(24:11):
Boutaire is a great place to deal with mental health
as well as addiction. So I felt heard, I felt
again safe, And those were the key things to me
that I will always say about embath and will always
promote to people. And I get everybody has a different experience.
Speaker 2 (24:32):
I'm sorry if you do.
Speaker 1 (24:34):
But for me, the people that work there wanted to
work there, if that makes sense, Like they you could
tell they wanted to work there.
Speaker 4 (24:41):
Yeah, I think that's really true. And that is our
goal is to provide that really safe, person centered care
that you feel seen, you feel heard, you feel understood,
and then we're gonna help get you to that next place.
It really is a place of transitioning from crisis into treatment.
It's not a treatment by itself, really, but it is
(25:02):
a catch place where we're going to take you and
hold you for a little bit and get you into
someplace you can start to do the work of healing.
And get that medical treatment, that emotional treatment, and that
substance you support when that's needed to.
Speaker 1 (25:17):
Is there anything else that I have not asked that
you guys want to talk about working in that space,
or that you think people should know about EmPATH or
about what you guys are doing to grow it anything.
Speaker 4 (25:32):
I think one thing people should know is that it's
a start. It's not going to be done after MPATH.
It really is. It's a specialized emergency department that does
what an emergency department does. It evaluates, it makes a plan,
and it helps you get where you need to be.
It just tends to do it in a little different
way that has an atmosphere quality of being more calming,
(25:55):
an open air space, a little more living room style,
but the the outcome is going to be similar, as
we want to get you into a place that you
can do the healing and the recovery.
Speaker 1 (26:06):
I forgot about mentioning this, but there's a sensory room
there as well, which I thought was a wonderful edition,
and something well thought out is that if you deal
with if you're listening, you deal with sensories issues, and
you're like, I can't be in a space like that
that's going to be too much. They do have rooms
they're designed for that.
Speaker 3 (26:26):
Correct, Yeah, correct, you have. We have four sensory rooms
and a lot of in an emergency room. It's flexibility,
and we really knew we're going to have a wide
range of patients coming in. It's an open MILIU, which
is different than the most emergency rooms. It's different than
(26:49):
all emergency rooms. And there are some people who that
is extremely helpful, just having some social interaction and being
open and being able to move around. And then there
are some people maybe they have some trauma, maybe they're
neurocognitively different and diverse, and they need a smaller room
that just makes them feel safe. We wanted to be
(27:11):
able to do both and how do we take care
of as many patients that can come through the right
way as we can.
Speaker 1 (27:18):
Well, if there's nothing else, I just want to say
thank you to both of you again for not only
being guests on this podcast and helping me promote something
that I feel very strongly about.
Speaker 2 (27:30):
But just the work you do at MPATH. So thank
you both again.
Speaker 4 (27:33):
Yeah, Charlie, thank you, and.
Speaker 2 (27:35):
I I hope nobody out there needs this.
Speaker 1 (27:38):
That is what I wish for everybody that you would
never need to go to MPATH.
Speaker 2 (27:43):
However, if you.
Speaker 1 (27:44):
Are feeling in a crisis situation, there are many steps
you can take. Obviously nine to one one is always
an option first, But if you have the ability to
get to MPATH, I would really, really really recommend and
if you are in that situation, because they will respect
you and handle you in a very safe way. And
(28:06):
so thank you so much to Michelle and rich both
of you again, your work that you do is life
saving because I would not be here. I can say
that very firmly. I would not be here today if
MPATH wasn't there. So thank you guys. And that's it
for another episode. I'll maybe get through one that I
don't cry at. We'll see I cryed every episode. But
(28:30):
that's another episode of Here we Go. Thanks so much
for listening. Please share with friends and family, talk about
this because these are programs we need, and.
Speaker 2 (28:40):
These are stories we need to share with each.
Speaker 1 (28:42):
Other so that you don't feel so alone when these
situations are happening. Awesome, Thank you so much to Zach
Halverson for producing the show.
Speaker 2 (28:51):
Today.
Speaker 1 (28:52):
We let Brett off the hook for just one episode,
but yeah, that's it. Thank you, and uh we'll hit
you next time with Here we Go.
Welcome to the second episode of season two of Here
we Go. Today is a very feels like emotional and
special day for me on this session because I am
almost at two and a half years sober and two
and a half years since I went into the place
(00:21):
that saved my life, and that place is m Path
right here in the Twin Cities in the Dinah area,
And milestones are big in the world of recovery, and
so two and a half years sober is a really
big deal to me. If you would have told me
that four years ago that I'd have a week sober,
(00:43):
I would have laughed in your face. So to have
this milestone is really big to me. And then to
share it with two people from MPATH who help build
this program and keep it going, it's a really special day.
So I'm excited to have two guests on Here we
Go Today, and this is Michelle Snyder. She's a system
(01:05):
director of mental health and Addiction and Clinical Services over
at m Health Fairviews MPATH and Rich Levine, medical director
of Behavioral Outpatient Services.
Speaker 2 (01:17):
Welcome to Here we Go US. Yeah, and you guys
can sneak close to those mics and sounds good. Get
up in there.
Speaker 1 (01:29):
First, I want to say thank you to both of you,
because as I've been doing this podcast, I've tried to
thank people along the way because it is a village.
It's a massive amount of people who do help you
to get into recovery and to get you to the
place you need to be. And I didn't even know
who you were, but the impact you've had with what
(01:54):
you've created with MPATH saved my life. And so I
just wanted to say thank you to both of you.
Speaker 3 (02:02):
You're welcome. We would also like to thank you taking
that leap of faith of stepping in and having somebody
take your life in your hands and help you through.
That's what we love to do, and it's very scary
for a lot of people to come in and so
we really appreciate when people come in and say I'm
(02:22):
here for help, and that's when we can do what
we can do.
Speaker 1 (02:25):
It was it's funny you say that, Bege use that
word because February fifth, twenty twenty three, I say.
Speaker 2 (02:32):
Is probably the scariest day of my life.
Speaker 1 (02:35):
And people are like, you were scared, you know, not
depressed or sad or other things, And I say, I
just kept saying I'm so scared. I'm so afraid leading
up to that day, even but it.
Speaker 2 (02:49):
Was probably the scariest day. Do you guys hear that
from people a lot?
Speaker 4 (02:53):
We do. You're really confronting yourself and your trauma and
your crisis, and people push it off often for as
long as they can and get to a point where
the fear of changing is finally not the worst. It's like, no,
now I'm ready and now I need it.
Speaker 2 (03:09):
Can we talk about the basic of mpaths.
Speaker 1 (03:11):
So if somebody is listening to this for the very
first time, I mean, I've.
Speaker 2 (03:14):
Talked about it a ton, but mpath.
Speaker 1 (03:18):
Itself, would one of you guys just talk about what
it is and why it was created?
Speaker 4 (03:25):
Yeah?
Speaker 3 (03:26):
So Rich, go ahead, Okay. So the EmPATH was designed
in a particular way to help somebody in a mental
health crisis in an emergency room. And we know the
emergency room is a wonderful place and they do wonderful
work in saving lives and stabilizing people to get them
(03:48):
to the next stage of whatever treatment it is. But
emergency rooms were not built for mental health crisis. They
are loud, they're noisy, they're busy, they move fast. There
are unsafe things in rooms, you have to stay in
your room, you're not allowed to move around because you
don't want to be walking into another room or a
(04:10):
busy nurse who's doing something, or another physician. So it's
not made for mental health crisis. And the EmPATH said,
wait a minute, we need to relook at what we're doing.
How do we help And we already talked about that
fear of coming in in a mental health crisis. When
you have chest pain, you're scared, but you know exactly
(04:30):
where you're supposed to go. When you're in a mental
health crisis, or you're feeling souicidal, or you're not sure
what's real or not real, you don't know where to
go and so you're extremely scared. And so we needed
to build something that could take somebody coming into a
crisis and help them start to relax, de escalate that
(04:51):
and think about it. And so we built this EmPATH
very purposeful of how do we take somebody out of
that busy emergency room, have space, have agency of people
being able to get up and move around, get something
to eat, get a warm blanket, be able to go
to the restroom when they want to. And then of
course the trained professional mental health staff to be able
(05:13):
to look at this, and I'll let Michelle talk about
all our different pieces of that. But we want to
be able to start medications and we want to start
therapy right away, try to de escalate, and then when
things are in a better light at that moment, we're
able to start making a plan for how are we
going to continue the momentum we started here in the EmPATH.
Speaker 1 (05:32):
There's so many things during this podcast. I hope somebody
listening might learn, first, if you're in crisis, an opportunity
for a place to go. Second, things that I didn't
know when I stepped foot inside those walls that I've
learned along the way that are very beneficial to getting help.
Speaker 2 (05:53):
One of them being.
Speaker 1 (05:54):
How dangerous it is to come off of alcohol and
you don't I mean, yeah, you get a hang people
think you get a hangover, but it is correct. I
think the only substance you can die from almost coming
off of they say one, I mean one of the
most danger yeah yeah, And so I think again these
(06:19):
places mpath is a great place to get help in
a way that will make sure you're safely doing it.
And so do you want to talk about some of
those pieces that, right, you're talking about.
Speaker 4 (06:30):
Well, one of the things that makes EmPATH really special
is that it's a multidisciplinary approach, right, So we're coming
at the crisis from at least three different areas. There's
a medication component and a physical safety and health component,
which you experienced in you know, getting those medical needs met.
(06:51):
There is a review for medication. Psychiatry is a big
driver of the health that you're going to get an EmPATH,
But like Rich mentioned too, there's also a therapeutic component.
There's licensed therapists who are there around the clock to
make the plan of care to help progress you through.
And then we have a whole nursing team who is
there to really drive those nursing cares and provide the
(07:13):
structure and support for the entire environment and make sure
that everybody is getting what has been ordered by the
providers and what they need to be safe. As we
calm everything down and put together a plan for how
to move forward on the road to safety or recovery.
Speaker 2 (07:32):
It's interesting.
Speaker 1 (07:33):
Okay, so I've never told this on air, but when
I went to MPATH, the people I worked with, I
first want to say, we're so empathetic which just fits
kind and you feel already so much shame, and usually
if you're in that state, you're already being so hard
(07:55):
on yourself to feel shame going in there or in embarrassed.
I had so much embarrassment going in there, And when
I was sitting in one of the first rooms, the
guy with me said, hey, like, you know, it just
felt like he knew who I was. Like he must
(08:15):
listen to power Trip or something, and he's like, I
just want you to know your privacy here is of
our utmost importance. He's like, you do not have to
worry about somebody releasing your information saying that you're here.
Speaker 2 (08:32):
And so he did say he.
Speaker 1 (08:34):
Knew who I was and he just wanted to know
that he wanted me to know my privacy was so important.
And he's like, that's not just for you, that's for everybody.
And so I thought the way that they engage with
the people there too, is really thoughtful. And I don't
(08:55):
know how you guys hire, but what a great job
to do that. And I think that's another thing for
people that may be looking for this help is I'm
so embarrassed, I feel so much shame that I need
this or that you know, I'm an adult, I should
have this figured out. And I would say that you
(09:15):
guys would probably agree like don't feel that going in right,
or like try to take that away.
Speaker 4 (09:22):
Well, and I think it's really hard to say don't
feel that. People are going to feel that. What I
think you want to do is ask some questions, Hey,
do you have rules about this? What is the plan?
And really get that information. Our goal is to provide
the most person centered experience because everyone's needs are going
to be a little bit different. A lot of the
(09:43):
problems are going to be the same, but how it's
experienced in the context that people live in is going
to be different. So things are going to be really
important to you. Bring them up and ask the questions,
have a conversation about it so that you can get
that reassurance.
Speaker 1 (09:57):
And I question about you don't necessarily have to be
use substance abuse to go in right, it's more based
on a mental health crisis, correct.
Speaker 4 (10:09):
Right, And they come in all different shapes.
Speaker 1 (10:12):
Okay, yeah, yeah, And so I think that's super important
to know because if you're listening, you're like, well, I'm
you know, I don't use anything, but I'm struggling. It's
still a great place to go. And one of the
things that helped me the most was bridging from this
crisis center to where I was going to go next,
because you can stay at MPATH. I stayed there for
(10:35):
almost three days because they had found me a place
to go, and I wanted to go what's called door
to door, so I wanted to go straight from MPATH
to a treatment facility, so they allowed me to stay.
I think they said the average stay is about two days.
Speaker 3 (10:51):
It's actually about twenty four hours.
Speaker 2 (10:53):
Really, Oh my gosh, you guys are good.
Speaker 1 (10:57):
But what I thought I want to want to talk
about is bridging the gap between your crisis stay there
and then going somewhere else. And how important that is
because if I would have gone home, I would have
probably just gone right back into the cycle.
Speaker 3 (11:13):
Yeah, it's one of our major factors of how the
EmPATH works and why we get such good results. I've
been doing emergency room care for twenty years in the
mental health field, and previous we would give resources, we
may even be able to give some appointments, we may
be able to give some medications, but ultimately we're just
(11:33):
saying we saw you for a couple hours. This is
what we're doing. Good luck, and what the MPATH is
able to do is give us some more time, be
able to make sure that the treatment plan that we're
going to do to send you home with is the
right treatment plan and that we're actually able to set
it up and do what we would like to do.
(11:54):
And sometimes that can happen in a couple hours. Sometimes
that takes three days. And we have the flexible ability.
We certainly it's not an impatient unit. We don't want
people staying there for a week. We would move you
on to an impatient unit if something was that severe.
But if we have that ability to bridge the gap
as you talked about and make sure that we have
the right discharge work, then we know we're going to
(12:18):
be successful and the patient's going to be successful. One
of the things that we measure when we look at
is not just how well are we getting people to
the right placement and discharging, but do they come back?
And so one of our things is and people talk about,
you've decreased the number of people that have to go
to impatient unit, so you must be just discharging and
(12:41):
fascin they must just come back to the emergency room,
and that's not the case. And in fact, wonder about
twenty percent of people coming back within thirty days to
maybe be fifteen for thirty days, fifteen percent for thirty
days of returning, which means we are setting up the
right outpatient, We are getting them the right plans so
they can't continue to take again the momentum that they
(13:03):
started in that EmPATH.
Speaker 4 (13:04):
Yeah, time to plan that transition is really important. And
that is one of the features and the gifts of
an EmPATH unit is that it's it's not quite as
rushed as an emergency department is Michelle.
Speaker 2 (13:18):
You mentioned it too.
Speaker 1 (13:21):
The tailoring of each person too, and the ability you
guys have to do that because.
Speaker 2 (13:27):
Maybe you need an outpatient.
Speaker 1 (13:28):
You know, there's so many options when it comes to treatment,
and tailoring it for people I think is so crucial.
What I want to go into just a very basic
thing quickly. So if let's say I'm let's say I'm
sitting at home and I am having suicidal ideation, I
(13:48):
am in a crisis situation, what would be your first
step with that path?
Speaker 4 (13:55):
So the first thing I would want people to kind
of think and is to reach out to some get
somebody on the phone, tell a family member that's in
the house, you know, let somebody else know, so that
you have some company while you're making that next decision.
That's really important is to have company. Wouldn't you say?
Speaker 1 (14:13):
My sister and my best girlfriends were the ones sitting
right next to me when we made the call, and
so it's exactly what you said.
Speaker 2 (14:20):
That's that's that safe.
Speaker 4 (14:21):
It was the best thing, right someone to kind of
encourage you, but also just to be there and to
decide if we have time to make a decision about
where to go, or do we need to call nine
one one and get help right this second, because it's
going to make a difference if EmPATH is is you know,
you've heard about it before, you're thinking that might be
(14:41):
a good thing for me. What you want to do
is start at the emergency department. That is that is
the place to start, which is over at Southdale.
Speaker 3 (14:50):
Yeah, just so people know that everybody would go through
the emergency room before you get to the EmPATH, and
we do that very purposely. We want to make make
sure that there isn't a medical issue going on that
we need to deal with first. A lot of mental
health will have some true medical issue that may be
either the cause or because of the mental health. There's
(15:12):
something else going on that we need to acutely take
care of medically before we start doing some of the
work that we do. And so everybody gets in, gets
that triage done. If everything is okay, then we bring
them over to the EmPATH as quick as we can.
Speaker 1 (15:26):
One of the things we've been talking about, all the
wonderful things, and we will continue to do so. But
it's really unfortunate. I think how few and far between
there are of these units, of these places to go,
not just I don't know if they're all called mpath.
You guys can let me know, but I think you
(15:47):
guys said earlier there were about fifty of them.
Speaker 2 (15:50):
Across the country.
Speaker 1 (15:51):
We know that our mental health crisis is much bigger
than that, and so what are the challenges with building
more of them? Why don't we see more of them?
You know, because on the outside it's like, well, why.
Speaker 2 (16:03):
Don't we have more of these? Like let's put them everywhere?
But talk about, as two people so.
Speaker 1 (16:08):
Heavily involved, what the challenges are with creating them and
sustaining them.
Speaker 4 (16:13):
Well, first I would want to make sure that we
share that every emergency department can assess and get you
to some safety and get some of these things going.
So EmPATH is just going to be a little bit
different because it's built and focused differently.
Speaker 1 (16:28):
And so yeah, we're not discouraging you from going into
the ear. We're saying this option is such a tremendous
I mean, this is such an option to.
Speaker 4 (16:36):
Have, and it's new, and it is, like you said,
emerging across the country, but I think internationally too, So
it really is sort of a spreading idea as we
in the industry recognize the benefits and how good it
is for the people who have a chance to go through.
Speaker 3 (16:54):
For the most part, I can take just a short
story on the side from that. We had a resident
from Scotland who really was interested in doing better mental
health care in their emergency rooms and obviously their medical
system is drastically different than ours, and so she reached
out and she came over for a month and a
half and worked in the MPATH with us and has
(17:17):
gone back to Scotland has been able to get one
set up in Scotland in Glasgow, not Glasgow, Edinburgh, Edinburgh,
thank you. And so these are the kind of things
that is really great about espousing the MPATH model in
(17:38):
it again, it's new. Anytime we start with something new
or different, the payments have to catch up. And this
is the hard part with the MPATH. A lot of
the work that we do is something that isn't to build.
Speaker 2 (17:54):
And yeah, insurance you're talking about.
Speaker 3 (17:57):
With traditional insurance companies, Medicare, Medicaid, they don't pay for
the time and the work to do the discharge plan
that we've already talked about that really helps set somebody up.
They'll pay for the crisis assessment that the therapist might do,
they'll pay for the visit that the psychiatrist might do.
But in the MPATH we do a lot more than
(18:18):
just that. We do some second touch points. We work
on making phone calls to try to get things set
up that doesn't get paid for. So what makes the
er helpful is they get people in and out really quickly.
One of the things that's great about the EmPATH is
we have time. But because we have that time, we
don't get as many people through as we would like
to because each person somebody may needs two hours and
(18:40):
somebody needs three days, and we want to make sure
that we meet each person where they're at.
Speaker 1 (18:46):
If do you, I don't know if you guys pread
answer this question or not. I'm sure you have your
own opinions on it, but if you don't feel comfortable,
let me know. But I talk a lot about the
connection between mental health and addiction and the mental health
and substance use and what I again, another great thing
about EmPATH and what you guys are doing and what
(19:06):
you're promoting for me. It ties the two together. You
don't just go in and get medication to be okay
and then leave.
Speaker 2 (19:14):
It's we have therapists, we have.
Speaker 1 (19:16):
You know, the ability to connect you with treatments, all
sorts of things that help. What are your beliefs or
what have you seen change in the years you've been
in work, because I do feel like it's relatively new
that we're saying these two things are always I would
I would, I would argue, and people can disagree. Tied together.
I think that they are always tied together. And so
(19:38):
I don't know if either of you have any experience
or something you wanted to add to that.
Speaker 3 (19:45):
Absolutely, Traditionally there was a belief and specifically for addiction
issue substance use issues that you would need to get
clean of the suf since and sober before we would
start to treat mental health. And we have learned over
(20:09):
the last twenty twenty five years that there isn't a
separation of that and we need to treat both at
the same time. Now we know if we don't treat
the depression, it's going to be really hard for the
alcohol use disorder to get treated, and vice versa. If
we don't treat the alcohol use disorder, your depression is
(20:29):
going to be really hard to treat. Because we're combating
those two things, it goes even a step further. We're
really starting to learn a lot more about just integrating
mental health into primary care, and we call it collaborative
care where we really work hard for our primary care
(20:49):
docs to have therapists and availability for psychiatrists because we
know we get better medical outcomes for diabetes like blood
pressure if we treat depression and we treat anxiety, and
so it's taking a step beyond even what you're describing
that it's a whole mind body connection. There's no doubt
(21:10):
with that, and it's partly what the MPATH worked so
well on it. And I'm curious for you if you
remember one team member a little bit more than another,
because we look at it as a team game. It's
not the medical provider, it's not the er doc, it's
(21:30):
not the nurse, it's not the therapist, it's all of
us together, the coordinator who comes out and gives you
your appointment information. We look at as all of us
are taking care of you. But I'm curious as somebody
going through if you thought, oh, there was one person
who was more involved, or if you actually thought I
had a bunch of people involved.
Speaker 2 (21:50):
I truly mean this.
Speaker 1 (21:51):
It felt like every interaction I had from the moment.
So I moved pretty quickly through the er and I'm
sure they try to do that on perper And then
you first have to go back and it feels a
little bit like going to jail, maybe like you know,
things are you have to give up your phone, you
shoelaces are taken out, and it's it's purposeful, there's a reason,
(22:12):
but it feels a little bit.
Speaker 2 (22:13):
It can be again scary.
Speaker 1 (22:15):
And the woman who helped me through that, and then
the woman who got me, I don't know if she
would have been a nurse or just hert nurse, but
who started taking my vitals and taking you know, I
sat in a chair there. It's where I stayed most
of the time. It was their kindness absolutely, not only
(22:37):
their education, like they knew what they were doing, but
it was their kindness and gentle ability to help me.
That was that was so excellent for me. That felt
like such a great experience because I needed that in
that moment, I had just spent thirty eight years beating
(22:59):
myself down and and I had just been in the
worst part of my addiction i'd been in, you know,
and it was so I needed that that gentleness and
that kindness way more than I thought I did. So
even when it was going up to the desk there
and asking for something, it was not like a it
(23:22):
was like a yes, of course you can. It was
just like a gentle And I say gentle because it
was so. It was just that it was done in
such a kind way and a soft way that made
me feel safe. And that's what I think I was
looking that it made me feel safe, and I needed
(23:44):
to feel safe, and I hadn't felt safe.
Speaker 2 (23:47):
In a long time.
Speaker 1 (23:49):
And then the coordinator or two I remember feeling very
heard because I kept saying, I need somewhere that will
treat my mental health. I kept saying that, like I know,
I'm not okay, and I need somewhere that will help
with my mental health. And so there are many places
you can go for treatment, but she said to me,
(24:11):
Boutaire is a great place to deal with mental health
as well as addiction. So I felt heard, I felt
again safe, And those were the key things to me
that I will always say about embath and will always
promote to people. And I get everybody has a different experience.
Speaker 2 (24:32):
I'm sorry if you do.
Speaker 1 (24:34):
But for me, the people that work there wanted to
work there, if that makes sense, Like they you could
tell they wanted to work there.
Speaker 4 (24:41):
Yeah, I think that's really true. And that is our
goal is to provide that really safe, person centered care
that you feel seen, you feel heard, you feel understood,
and then we're gonna help get you to that next place.
It really is a place of transitioning from crisis into treatment.
It's not a treatment by itself, really, but it is
(25:02):
a catch place where we're going to take you and
hold you for a little bit and get you into
someplace you can start to do the work of healing.
And get that medical treatment, that emotional treatment, and that
substance you support when that's needed to.
Speaker 1 (25:17):
Is there anything else that I have not asked that
you guys want to talk about working in that space,
or that you think people should know about EmPATH or
about what you guys are doing to grow it anything.
Speaker 4 (25:32):
I think one thing people should know is that it's
a start. It's not going to be done after MPATH.
It really is. It's a specialized emergency department that does
what an emergency department does. It evaluates, it makes a plan,
and it helps you get where you need to be.
It just tends to do it in a little different
way that has an atmosphere quality of being more calming,
(25:55):
an open air space, a little more living room style,
but the the outcome is going to be similar, as
we want to get you into a place that you
can do the healing and the recovery.
Speaker 1 (26:06):
I forgot about mentioning this, but there's a sensory room
there as well, which I thought was a wonderful edition,
and something well thought out is that if you deal
with if you're listening, you deal with sensories issues, and
you're like, I can't be in a space like that
that's going to be too much. They do have rooms
they're designed for that.
Speaker 3 (26:26):
Correct, Yeah, correct, you have. We have four sensory rooms
and a lot of in an emergency room. It's flexibility,
and we really knew we're going to have a wide
range of patients coming in. It's an open MILIU, which
is different than the most emergency rooms. It's different than
(26:49):
all emergency rooms. And there are some people who that
is extremely helpful, just having some social interaction and being
open and being able to move around. And then there
are some people maybe they have some trauma, maybe they're
neurocognitively different and diverse, and they need a smaller room
that just makes them feel safe. We wanted to be
(27:11):
able to do both and how do we take care
of as many patients that can come through the right
way as we can.
Speaker 1 (27:18):
Well, if there's nothing else, I just want to say
thank you to both of you again for not only
being guests on this podcast and helping me promote something
that I feel very strongly about.
Speaker 2 (27:30):
But just the work you do at MPATH. So thank
you both again.
Speaker 4 (27:33):
Yeah, Charlie, thank you, and.
Speaker 2 (27:35):
I I hope nobody out there needs this.
Speaker 1 (27:38):
That is what I wish for everybody that you would
never need to go to MPATH.
Speaker 2 (27:43):
However, if you.
Speaker 1 (27:44):
Are feeling in a crisis situation, there are many steps
you can take. Obviously nine to one one is always
an option first, But if you have the ability to
get to MPATH, I would really, really really recommend and
if you are in that situation, because they will respect
you and handle you in a very safe way. And
(28:06):
so thank you so much to Michelle and rich both
of you again, your work that you do is life
saving because I would not be here. I can say
that very firmly. I would not be here today if
MPATH wasn't there. So thank you guys. And that's it
for another episode. I'll maybe get through one that I
don't cry at. We'll see I cryed every episode. But
(28:30):
that's another episode of Here we Go. Thanks so much
for listening. Please share with friends and family, talk about
this because these are programs we need, and.
Speaker 2 (28:40):
These are stories we need to share with each.
Speaker 1 (28:42):
Other so that you don't feel so alone when these
situations are happening. Awesome, Thank you so much to Zach
Halverson for producing the show.
Speaker 2 (28:51):
Today.
Speaker 1 (28:52):
We let Brett off the hook for just one episode,
but yeah, that's it. Thank you, and uh we'll hit
you next time with Here we Go.
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Season Two Out Now! Law & Order: Criminal Justice System tells the real stories behind the landmark cases that have shaped how the most dangerous and influential criminals in America are prosecuted. In its second season, the series tackles the threat of terrorism in the United States. From the rise of extremist political groups in the 60s to domestic lone wolves in the modern day, we explore how organizations like the FBI and Joint Terrorism Take Force have evolved to fight back against a multitude of terrorist threats.
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
NFL Daily with Gregg Rosenthal
Gregg Rosenthal and a rotating crew of elite NFL Media co-hosts, including Patrick Claybon, Colleen Wolfe, Steve Wyche, Nick Shook and Jourdan Rodrigue of The Athletic get you caught up daily on all the NFL news and analysis you need to be smarter and funnier than your friends.