January 12, 2026 • 48 mins
The quietest lifesaving moments often happen between a slammed door and a deep breath. We sit down with crisis mental health clinician and SWAT negotiator Jessi Beyer to unpack what it really takes to bring a volatile scene down, earn trust in minutes, and move someone from danger toward safety. Jessie works nights alongside law enforcement on 911 calls involving suicidal ideation, psychosis, and severe substance use, and she opens up about the tools that work when nothing else seems to.
You’ll hear how a winding path from vet school to EMT to graduate studies in trauma and terrorism shaped a clinician who knows her lane and thrives in it. Jessi breaks down tips for de‑escalation you can use anywhere: matching tone without escalating, reflecting the exact pain under the behavior, and delivering the one line that can drop someone from a ten to a six. We talk about realistic definitions of success in crisis care, why “alive tonight” is often the right metric, and how clean handoffs and community resources reduce reliance on emergency rooms and revolving-door hospitalizations.
We also confront a blind spot: up to 75% of people who die by suicide see a primary care clinician within a year. Jessi offers practical, time‑smart suicide screening questions any clinician can use, along with ways to sit in discomfort and listen without rushing to fix. And for trauma survivors who don’t thrive with talk therapy, we explore evidence‑supported alternatives like dance/movement therapy, canine- and equine-assisted work, and ecotherapy, drawing from Jessi's book on natural therapies.
If you’re a clinician, student, or curious listener, this conversation delivers actionable skills, candid stories, and a humane framework for care under pressure. Subscribe, share with a colleague, and leave a review to tell us which de‑escalation tip you’ll try this week.
Connect with Jessi Beyer at:
Website: https://jessibeyerinternational.com/
Instagram: @itsjessibeyer
Please connect and say hello >>> Email me!
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Virtual shadowing is an important tool to use when planning your medical career. Whether as a doctor, a physician assistant, a therapist or nurse, here Shadow Me Next! we want to provide you with the resources you need to find your role in healthcare and understand your place in medicine.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Ashley Love (00:00):
Hello, and welcome to Shadow Me Next, a podcast
where I take you into and behindthe scenes of the medical world
to provide you with a deeperunderstanding of the human side
of medicine.
I'm Ashley, a physicianassistant, medical editor,
clinical preceptor, and thecreator of Shadow Me Next.
It is my pleasure to introduceyou to incredible members of the
(00:22):
healthcare field and uncovertheir unique stories, the joys
and challenges they face, andwhat drives them in their
careers.
It's access you want andstories you need.
Whether you're a pre-healthstudent or simply curious about
the healthcare field, I inviteyou to join me as we take a
conversational and personal lookinto the lives and minds of
(00:43):
leaders in medicine.
I don't want you to miss asingle one of these
conversations.
So make sure that you subscribeto this podcast, which will
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And follow us on Instagram andFacebook at Shadow Me Next,
where we will review highlightsfrom this conversation and where
I'll give you sneak previews ofour upcoming guests.
(01:03):
Today's guest does work thatmost people never see and very
few people could actually do.
Jessie Bayer is a crisis mentalhealth clinician who responds
alongside law enforcement to 911calls involving suicidal
ideation, psychosis, and severesubstance use.
She's also a trained negotiatoron her SWAT team.
(01:25):
When situations are volatile,emotional, and dangerous, Jessie
is the mental healthprofessional in the room,
helping bring things down, keeppeople alive, and move them
toward safety.
Her path here is just aspowerful.
EMT training, a background inpsychology, graduate work and
(01:45):
trauma, crisis intervention,military psychology, and
terrorism studies.
Every piece of her story hasshaped the way she shows up in
moments that matter most.
In this episode, we talk aboutde-escalation, emotional
intelligence, knowing your rolein medicine, and what it really
means to be a steady presence inchaos.
(02:06):
Please keep in mind that thecontent of this podcast is
intended for informational andentertainment purposes only and
should not be considered asprofessional medical advice.
The views and opinionsexpressed in this podcast are
those of the host and guests anddo not necessarily reflect the
official policy or position ofany other agency, organization,
(02:27):
employer, or company.
This is Shadow Me Next withJesse Beyer.
Jesse, thank you so much forjoining us today on Shadow Me
Next.
I am thrilled to hear what youhave to say and the incredible
story you have to bring to ustoday.
Jessi Beyer (02:40):
Oh, well, thank you for having me.
I'm I'm super excited to talkabout it and figure out how we
ended up in this world that Icurrently work in.
So I'm super happy to be here.
Ashley Love (02:48):
Which is a really incredible world and one that is
um I, you know, I say this tolike our helicopter nurses and
our critical care physicians,that their their life is high
stress, high reward, but reallynothing holds a light to what
your high stress, high rewardsituation is, which of course
we're gonna break down.
But Jesse, we're gonna start atthe beginning here because you
(03:11):
gave me a little teaser and Ijust cannot wait to talk about
it.
Tell them how you ended up inthis field of medicine, is what
we're gonna call it, in thisfield of medicine that you are
experiencing right now.
Jessi Beyer (03:24):
Yeah, so this is definitely kind of a weird
story.
So going back even a little bitbefore the teaser that I gave
you, when I was in high school,um, my boyfriend at the time
attempted suicide.
And that was just a really,really difficult night for me.
I had been his big supportsystem.
I was the one who called 911 toprevent that attempt from being
(03:45):
completed.
And in kind of the aftermath ofthat, of course, law
enforcement shows up, he getstaken to the hospital.
Um, there was a social workerthat showed up with the cops as
well.
And she talked to me for alittle bit, you know, hey, are
you okay?
She gave me her card.
You know, if you need anything,you can reach out.
And I was like, that's cool.
And then promptly put herbusiness card in my bathroom
drawer and like didn't thinkabout it.
(04:05):
So there was this seed that wasplanted in my mind that I
really didn't think I could domuch with.
Um, and it just kind of satthere for a while.
And then when I decided I, youknow, wanted to go to college
and was figuring out what Iwanted to do, my freshman year
of college, I actually went toveterinary school at the
University of Edinburgh inScotland.
For context, I grew up inOregon.
So that was quite a departurefrom the world that I was used
(04:28):
to.
And I got there and I was like,well, this is not what I
thought it was gonna be.
It was um a bit of a moment ofbreaking the rose-colored
glasses of what I thoughtveterinary medicine was.
And what really crystallizedthat for me was recognizing that
the care stops when the moneyruns out or the animal is no
(04:49):
longer of value to the humans,not when the job is actually
done.
And for my personality, I'mvery much a like complete it at
all costs type of person.
And so that really, it was justlike this whole moral thing of
I don't think I can do this forthe rest of my life.
I don't even think I can dothis for the rest of the
five-year degree program.
So I was like, I need to getout.
I need something where um I canjust I it's it's me and the
(05:13):
patient, and I can complete thisjob.
And so I went to Canada and Igot my EMT license.
And I was like, I'm gonna gointo emergency medicine because
it's just me and the patient andthe back of an ambulance, and
my job is to keep them alive.
There's no politics involved.
Anyone who works as an EMTknows that there are tons of
politics in EMS, but my likenaive self thought that that's
what I was gonna do.
Um, and I loved it.
(05:33):
Like that EMT course that Itook was one of my favorite
educational experiences thatI've ever had in my life.
I just absolutely loved it.
So I was like, okay, I'm gonnastay in Canada, I'm gonna get my
paramedics license, I'm justgonna work in emergency
medicine, it's gonna be great.
And uh my parents were like,yeah, but babe, you need a
college degree.
Like you, you have to go tocollege.
And I was like, but do I?
(05:54):
And they're like, yes.
And so I was like, fine.
So I went back to the States umand I finished my degree in
psychology at the University ofMinnesota.
It was a bit of a protestdegree, I will say.
I was kind of like, I don'treally want to be here.
I don't know what I want to do,but psych is somewhat
interesting to me.
And so what the heck, I'll goahead and do it.
And my uh one of my electiveclasses, my senior year, maybe
(06:18):
my junior year, one of my lasttwo years, um, was on
nature-based therapies.
And that really turned the tidefor me because that piqued this
interest for me.
Um, back after my high schoolboyfriend had attempted suicide,
I went to one day of therapy umafter that.
And it was just, it wastraditional talk therapy, like
nothing crazy.
I hated it.
I was so uncomfortable.
(06:38):
I literally ran out of thebuilding, like full on running
out of the building.
Um, and I never went back.
And I thought that that was myoption, was like talk therapy or
bust, essentially, as I wastrying to heal from this.
And so learning that there werethese other modalities that are
out there, there's other waysto heal from traumatic events.
That really got me backinterested in the world of
psychology.
So ended up finishing thatdegree.
(07:00):
My capstone was on differentintegrative trauma therapies,
movement-based, nature-based,animal-assisted, all these
different things.
Um, and then I just startedspeaking and talking.
And I did a lot of work ineducation, peer support
education, um, integrativetherapy education for a number
of years until I landed in thespace that I landed in now, um,
which, as we talked about in theintro, I do crisis mental
(07:22):
health work alongside lawenforcement.
I'm a negotiator on our SWATteam.
Um, and another littlebreadcrumb for this is after I
graduated college, undergrad,uh, before I went to grad
school, I um I did a ride alongwith our local deputy and his
mental health professionalpartner.
And we went to a call where itwas a domestic violence
situation and they ended uphaving a negotiator come out.
And I remember sitting in theback of this patrol car and I'm
(07:44):
like, hey, that's kind of cool.
Like, could I ever do that?
And they're like, no, you haveto be a cop to be a negotiator.
And I was like, oh, okay.
And again, filed it in thebathroom drawer kind of thing.
Um, and ended up being anegotiator, not being a cop.
So it's interesting how thisworld comes together.
Um, and I guess I in thatprocess, I skipped over grad
school, which is prettyimportant.
Um, for me, I took a couple ofyears between undergrad and grad
(08:07):
school.
Um, I really am glad that I didthat.
I was told, you know, if youstop school, you're never gonna
go back.
And I have learned through myown experience and through the
experience of a lot of myfriends that that is not the
case.
Um, so I took a couple of yearsand then I went to grad school
for critical psychology andhuman services.
Um, and I focused a lot of myeducation on trauma and crisis
(08:28):
intervention.
So I got to design some of myown courses.
For example, I took a course onPTSD in military and first
responder populations.
I took a course entirely onsexual assault, which sounds
like very heavy and traumatic,but was just wildly interesting
to delve into all the differentelements of that.
Um, so really amazingeducational experience.
Um took another couple of yearsoff and then went back and got
(08:51):
a second master's in militarypsychology with a focus in
terrorism.
Um, and all of these like weirdeducational things that I've
done over my life have set me upreally well for the work that I
do now and given me a veryunique perspective to bring to
the table.
Um, so yeah, in like a verylong nutshell, that is my my
journey to where I am today.
Ashley Love (09:11):
It's such a cool journey, and I love it because
um, even just speaking with youbriefly for a couple of minutes,
all of a sudden, all of thesedifferent elements, all of these
different pieces of your lifehave really beautifully just
combined into this perfect rolefor you, really.
And you mentioned a couple ofthings, and I'm so glad that you
brought them up.
First of all, um, you just litup when you talked about your
(09:32):
time as an EMT in Canada.
And and I love to hear thatbecause I think so often people
think of their role as an EMT umas being perhaps a stepping
stone to something else.
Like so, for example, I'm a PA,I'm a physician assistant, and
we um a lot of students will gettheir patient contact hours as
EMTs.
And speaking with so many of mycolleagues, they say, Ashley, I
(09:53):
almost did not go to PA schoolafter this because I enjoyed
being an EMT so much.
Um, so I'm so glad you broughtthat up.
It's such a fantastic career,and I would imagine really,
really, really sets you up forthe work that you do right now,
communicating um with some ofthe different people, law
enforcement agencies, firedepartments, SWAT.
Um, it's a whole differentlingo, right?
(10:14):
And you speak it, I wouldimagine, largely because of some
of the stuff you encountered asan EMT.
Jessi Beyer (10:19):
Yeah, absolutely.
It's it's a wonderful,wonderful career.
Um, and through my work as anEMT, I got to do a lot of like
sports events and youth sportsevents, which being a child
athlete myself, I was like, socool.
I'm back in basketball land.
Um, so that was really fun.
And then I also did work as anEMT with search and rescue.
So now we're talking likebackcountry, austere, like
things are breaking and we haveto fix it with a stick kind of
(10:40):
thing.
Um, hopefully that's why I'mthere as I bring more stuff.
But it's that type ofenvironment.
Um, and just all these amazingexperiences.
And so for any of yourlisteners, any of your audience
that is considering emergencymedicine as a path, I will say
now I love working with EMTs inthe role that I have now because
they're often the ones that lawenforcement and I show up
(11:00):
first.
We do safety checks, immediatede-escalation, whatever that is.
And then if the person needs toget transported to the
hospital, I'm not driving them.
The cop isn't driving them.
It's an EMT crew that comes andtakes them.
So being able to hand off tothem, not only speak their
language to have thatprofessional relationship, but
also that empathetic touch thatthat EMT brings because they
(11:21):
have that ride into the hospitalto just chit-chat with that
person.
Like there's no medicalintervention necessarily that
needs to be done.
But if you're thinking about acareer in emergency medicine,
it's not just I'm treating heartattacks and I'm treating broken
bones.
It's I'm talking to a kid thatwants to kill themselves, or I'm
running around with a searchand rescue dog trying to find
(11:42):
someone lost in the middle ofthe woods.
Like there's so many differentelements to that career field.
Um, and whether it's a steppingstone or a permanent place,
like I think it's a wonderfulentry into medicine.
Ashley Love (11:52):
No, I totally agree.
It is a fantastic opportunityto really see humanity,
unfortunately, at its mostsignificantly painful moments,
which we're gonna talk a lotabout here in just a couple of
minutes.
But before we get too far intothat, let's talk about your role
because I think I think it isjust so interesting.
(12:14):
So you really you sit at thiscrossroads, right, of medicine,
of mental health, and of publicsafety, which I think is is such
a cool and unique place for youto be.
Tell us what you do when you goon scene with law enforcement
or fire rescue, when when youshow up in the morning, what
does your job look like?
Jessi Beyer (12:34):
Yeah.
Well, I will specify that Idon't show up in the morning, I
show up at night.
Um, so I work, I work swingshift, um, which is two to
midnight.
And uh the reason that Ihighlight that is for a number
of different reasons.
But one is that's when a lot ofcrises happen.
And so if you're working in anysort of first response or
emergency health care, might notbe a nine to five.
(12:55):
So just kind of prepareyourself for that.
Um, and the other thing is thatoftentimes I'm the only mental
health resource that's availableat that time.
Private practice is closed,substance use disorder treatment
centers are closed.
It's kind of just me.
And so I frame that beforegoing into like what I actually
do.
So I respond alongside mostlylaw enforcement, sometimes EMS,
(13:16):
sometimes both, um, to 911 callsthat have some sort of
behavioral health element.
And the three most common onesfor me are suicidal ideation,
psychosis, and substance usechallenges, andor a
conglomeration of multiple ofthose.
When I show up on scene, myrole is twofold.
One is the immediatede-escalation.
So we've had folks that haveknives, we have folks that are
(13:40):
screaming bloody murder, we havefolks running down the middle
of the highway at two in themorning.
How do we take this from level10 to like maybe a level three
or four where we can actuallyhave a conversation about next
steps?
Part two of my role is what arethose next steps?
I will always tell people Iwould be a terrible private
practice therapist.
Um, God bless people that dothat, but that is not me.
(14:01):
I love the immediate work andthen passing them off to someone
else for longer-term care.
And so part of my role is thatpass-off, right?
What resources are available?
Um, where can we put you ortake you or connect you with so
that you don't continue havingthese crises?
How can we reduce the alliancewith the reliance on the 911
system on hospitalization, lookat community-based care?
(14:23):
And that really spanseverything from securing bus
tickets for people, like buspasses, um, housing, treatment
for mental health, for physicalhealth, for substance use
disorders.
Um, we have a specific resourcein our county for um temporary
fostering of pets while peoplego to detox.
And so it's this interestingworld of knowing all of these
(14:44):
different resources, knowing whohas a wait list, who doesn't,
how do you access it, what arethe access criteria and
admission criteria, and kind ofcrafting this plan with the
client of, okay, great, we fixedthe immediate crisis.
We're no longer screaming.
What do we do now?
Where do we take you next?
And so that is just as much apart of my job as that immediate
de-escalation risk assessmenttype stuff that I do.
Ashley Love (15:05):
That is so cool.
Thank you for breaking thatdown so well for us.
I think there's a couple ofways I want to go with this.
Number one, immediatede-escalation.
I'm like, I'm having flashbacksto moments of like the last
three days with my children,really, because there's so many
times I've said, is this acrisis?
Are we in crisis right now?
And they've said no.
I'm like, well, they'rerescreen.
Let's please calm down.
(15:25):
But um, the immediatede-escalation, I would love to
hear some of the tools that youuse for that, right?
And and this is number one,this is for your role because
obviously you use this everyday.
I in dermatology, I am notchasing people down a highway,
usually.
However, there are definitelymoments when I realize I've
walked into a situation that'svery, very hot, very, very tense
(15:46):
for whatever reason.
Now it's not as typically asdangerous as your situations,
but knowing some of these toolsfor de-escalation, especially in
healthcare, is super importantto get to the point quickly with
some of these patients.
Say, what are um, tell us afew, if you can, some of these
tools that you use.
Jessi Beyer (16:02):
Absolutely.
I'll ground this in a scenariothat happened a couple months
ago, perhaps.
I took a client to thehospital.
She had been endorsing suicidalideation.
She wasn't willing to do asafety plan and stay at home.
So we're like, okay, we'regoing to the hospital.
Um, and this particularclient's story, she had a very
difficult sexual relationshipwith her husband, a lot of
coercion, a lot of obligatoryinteractions there, just very
(16:24):
not healthy, lots of traumabackground going on there.
And so we're in this hospitalroom, and the nurse comes in and
is like, okay, I need to drawyour blood.
And she's like, No, you don't.
Why do you need to draw myblood right now?
And they started kind of goingback and forth at that.
And the nurse just got stuck inthis cycle of, well, I
understand what you're goingthrough.
And the client was like, No,you don't.
(16:44):
You have no idea what I'm goingthrough.
No, trust me, I do.
I've seen a lot of people inyour position, yeah, but you
don't understand what I'm goingthrough and just button heads.
And I was standing in the roomand I could just feel the
tension in everyone just startgoing up.
Um, and I think that thathappens a lot because as
healthcare workers, especiallyin the emergency department, you
kind of have seen it all.
(17:05):
Like you've probably seenpeople in very similar
situations to this woman'ssituation.
And so in your mind, you'relike, no, I I get it.
Like I've seen people in yoursituation before, but in that
client's mind, they're like, no,you haven't.
You don't know my story, youdon't know my situation, you
don't know what's going on withme.
And so I say all of that tohighlight the point that the
biggest thing that you can do interms of de-escalation is set
(17:27):
aside yourself, set aside whatyou've seen, your experience,
your perception of this client,and sit with that person in
their moment of pain.
So that can kind of take one oftwo ways.
If you have a very sad,depressed, crying that type of
person, it's going to be calmer.
You know, this is more of myclient voice when I'm talking
with someone who's in that typeof emotional state and it's very
(17:50):
validating and labelingemotions.
And yeah, I mean, it soundslike you're really, really going
through a hard divorce rightnow.
Like whatever that is, right?
It's getting on their level.
It's that calm type ofreflecting the emotions that
they're sharing with you.
If you have someone who'scoming in and they're screaming
and they're mad and they'rethis, I'm gonna reflect that a
little bit.
It's gonna be more, yeah, dude.
I get it.
Like you were out there, youwere just minding your own
(18:12):
business, and then all of asudden you're hog tied and
brought to the hospital.
I'm doing the same skill ofreflecting the emotion of I
don't want to be here.
I brought, I was brought hereagainst my will.
I'm frustrated, I'm mad, I'mwhatever.
But I'm matching that a littlebit and then slowly working my
way back down.
Sometimes it works if you cancome in with a really, really
escalated person and you arelike barely, barely speaking,
(18:34):
because then they're like, Ican't hear you, and then they
bring themselves downimmediately as well.
But sitting with them in thatspace sometimes means you're mad
with them.
And so if you can bringyourself to that level, have
that conversation.
Usually what happens with folksthat are really, really
escalated is if you can get onereally good reflection in there.
So one sentence of, yeah, itsounds like you were minding
(18:55):
your own business and then allof a sudden all these cops
showed up, or yeah, it soundslike you were having a really
difficult fight with your wife,and then she threw in this
really hard insult or whatever.
I don't know, whatever it is.
If you can get one really goodone of those in there, they will
go from a 10 to a six almostinstantaneously.
Um, and one story for this,just to put a more a little bit
more color to it, we were out ona SWAT call, I think it was
(19:17):
like three in the morning.
Um, and this kid, he was about10 years old.
He had just watched his fathershoot his grandfather.
Um, and he got drug out of bedby law enforcement to get him
out of the house to get him tosafety.
Um, and so I'm talking with himand he's pacing, he's talking a
million miles an hour.
He's talking about like threelevels of volume louder than he
(19:38):
needs to be, and just going onabout how disappointed he is in
his dad and how his dad hasn'tbeen there for birthdays and
hasn't done this and hasn't donethat and all these different
things.
And he just was like at hisdad.
And I said to him, I was like,Hey, it sounds like you've been
looking for more from your dadfor a really long time.
And he was like, Yeah, and isfull possible.
(19:59):
Changed.
He sat down on the curb.
He lowered his volume.
He slowed his speech.
And so just that one line, Iwas even sitting there being
like, that worked better than Ithought it was going to work.
Like I shocked myself with howthat line worked.
It's not always that easy.
But my point is, if you can getthat one, one good reflection,
one moment of rapport, that isoften enough to take a really
(20:21):
escalated person down a fewnotches and then as a provider,
help ensure your safety in thatsituation as well.
Ashley Love (20:27):
Absolutely.
It's reading between the linesand it's so much easier said
than done.
I like to call it the hiddengem in clinic.
And sometimes it's somethingthat they say offhanded as an
aside that if you can recognizeit, if you can pick it up, um,
and just try to scooch it in aswell.
(20:48):
I mean, you can't attack it.
You cannot attack these things.
But if you just kind of easeinto it, like you mentioned, I
heard you say X, Y, and Z.
And oh, by the way, this onetoo, they feel heard, they feel
understood.
And like you said, it canabsolutely de-escalate a
situation.
Um, or even and even if theyare already calm and collected,
but maybe withdrawn and notsharing, sometimes it can help
(21:11):
open them up as well.
So, oh, thank you so much forsharing those.
Those are really, really goodexamples.
I love it.
And something that before Imove on that I want to um that I
want to touch on real quick,you mentioned that most of the
calls that you are that you'rethat you go to um late at night
are suicidal, suicidal ideation,psychosis, and substance use.
But then you just mentioned a10-year-old.
(21:32):
Do you see adults and childrenthen?
Are you involved in both?
Jessi Beyer (21:36):
Yes.
So the youngest client thatI've ever had was six, and the
oldest was late 80s, early 90s,I think, somewhere in that about
to go into the nursing hometype of age range.
Um, so yeah, I I respond toeverything.
Um, anything that touches the911 system.
Um, we have a lot of parentsthat call in on their kids
because the the we have it'sfunny, I'm gonna say this, and
(21:59):
for me, this is like, oh, thisis a Tuesday, and it's gonna
sound wild to anyone who is nota part of my world.
Um, we have a kid who hisparents call 911 on him a lot
because he continually tries tokill his dad with a knife.
Um, and so we're figuring outhow to navigate that situation.
So we have that side of things.
Um, we have a lot of folks thatcall in on loved ones who have
endorsed suicidal radiation insome capacity.
(22:21):
So husband sent me a textsaying goodbye for real, or
daughter posted a bottle ofpills on Snapchat.
We get a lot of those.
Um, and then we get a lot ofconcerned citizen calls for the
person who's running down thehighway at two in the morning or
different things like that.
So it is a very, very widegroup of people that I work
with.
Ashley Love (22:39):
Which I think is really interesting.
And because there's certainelements of medicine, as you can
imagine, that are very, veryfocused when it comes to who you
see and what you do.
Um, and this career sounds likeit's very broad, which I think
to some people, uh, to a lot ofpeople would be quite
interesting.
Um, you mentioned a couple ofthings that I think are really
hot in media right now, and thatis recognizing some of these
(23:02):
signs that we're seeing ofsuicidal ideation, primarily
self-harm, things like that,which this is something that you
see all the time, all day,every day.
And um, of course, we want wewant people to report this.
Any little thing, it isabsolutely worth checking up on.
Um, let's keep each other safe,the whole, the whole nine
yards.
(23:22):
What does success for you looklike in crisis negotiation, even
when sometimes the outcomesmaybe aren't perfect?
Speaker 1 (23:31):
That is an amazing question.
Like, wow, first of all,awesome.
I love that question.
For me, um the first thing thatcomes to mind, and this is
maybe a bit um simplistic, butit's keeping them alive.
And the reason that I I saythat, and everyone's like, oh,
it's healthcare, of course.
Our goal is to keep them alive,but there's a lot of commentary
(23:54):
in the media right now aboutwell, law enforcement just
arrests people that have mentalhealth challenges and we just
take them to jail, and there'sall these things that are you
know wrong with that.
And I agree, jail is not theideal situation for folks,
right?
That's not the ideal healingscenario.
But when intensive outpatienthas wait lists a mile long, when
(24:15):
inpatient is full and there'sno beds available, I can't get
someone well if they are notalive.
And so if that means thatthey're going to the hospital or
they're going to jail, that's awin.
I would say that my, you know,ideal situation is this um, you
know, terribly depressedteenager that I speak with, and
(24:36):
then we make this amazing safetyplan, and then they're
de-escalated and they get tostay at home and they go to
school the next day, and youknow, they email me six months
later and they tell me thatthey're doing amazingly.
I've had those.
I had this one kiddo that Itook her to the hospital dozens
of times, sponsoring these forceon her dozens of times to get
her to the hospital.
(24:56):
Um, just chronic, chronicsuicidal ideation.
And I was given her parentslike resources last grade and
center.
I could not figure out what todo with this kiddo.
And then she just dropped offthe face of the earth for like
six months.
And I was talking with my lawenforcement partners, and
they're like, Yeah, we haven'theard from her either.
And I was like, Well, she'seither better or she's dead, and
I don't know which.
Um, and I I heard from mydeputy a couple months after
(25:19):
that.
He's like, Hey, I ran into herin a coffee shop.
And I was like, And he's like,Yeah, she's doing amazing.
Like she went to inpatienttreatment down in California for
a couple months.
She got a job, she is trainingher service dog.
Like, she's doing so well.
And she told me to tell youthank you.
And this client emails me everycouple months.
I get a little email on myinbox that's like update.
And then she tells me some newthings that are going on in her
(25:41):
life.
So those are like amazing wins.
And I love those and I cherishthose.
And when I don't have goodcalls, those are the ones that I
go back to of like, no, you'restill good at your job.
It's okay, you still helppeople.
Um, but at the end of the day,it is keeping them alive enough
to get them to a longer-termresource, is really what success
looks like in my role in someof these complex situations.
Ashley Love (26:01):
Thank you for that answer.
It is, like you said, it seemslike a very simplistic idea.
But you're right.
And a lot of people might notview that as an ideal success.
Um, but I really the thepicture that you just painted of
I can't help somebody ifthey're dead.
And if they're in jail, mostlikely they're still alive.
It reminds me a lot of thesituations when people go to the
(26:24):
emergency room, which I've I'msure as an EMT, you saw this.
People have these chroniclifelong conditions.
And for whatever reason, thatday they've chosen today is the
day that I'm gonna go to the ERand get answers.
That's not what the ER is for.
You're gonna show up to the ER,they're going to see, are you
going to die in a couple ofminutes?
(26:45):
No, we're getting you out ofthe ER, you know, that's kind of
similar.
So it it just it reallyhighlights the fact that as
clinicians and as as peoplelooking to healthcare as a
career, you have to know yourrole in medicine.
And we each play a role inmedicine, right?
You've mentioned before, whichI I do want to come back to as
(27:06):
well, that you appreciate thefact that you see people in
crisis in mental health crises,but you are not managing their
care long term.
There are other clinicians whoI'm sure would not know what to
do in crises and serious men,they don't know how to chase
somebody down the interstate,right?
But they appreciate thatlong-term care relationship.
This is the same thing, youknow, we have to manage our
(27:28):
expectations as clinicians andwhat type of medicine we're
going to enter.
And as patients, we have tomanage their expectations of
what they're going to get inthat area of medicine, right?
It's why our ERs are so busyright now.
As, like I said, as an EMT.
I'm like preaching to the choirright now.
Jessi Beyer (27:44):
Yeah, yeah.
And frankly, I've been in theER more as a mental health
professional than I was as anEMT because we get a lot of
folks that end up there as well.
Um, but your point is so valid,and that's something that I
think I I kind of had to learnthe hard way when I got into
this field because I definitelycame into it a little bit
arrogant.
I was like, I'm the mentalhealth professional.
Um, I know what to do.
I'm gonna get these peopleconnected with this resource and
(28:06):
that resource, and they'regonna be fine, and then I'm
never gonna see them again.
Obviously, it doesn't happenthat way.
And so I had to recognize thatmy role is this 10 to 60 minutes
that I have with you.
And if I can be a little brightspot in your chaos darkness of
a life, I have done my job.
(28:27):
And whatever happens once Itake them to the hospital or
once I refer them to detox oronce I find them housing, like
that's out of my control whatthey do in that situation as
well as what that provider doesin that situation.
But I can be really, really,really good at my 10 to 60
minutes.
And that's really what I'vefocused on.
And I would encourage anyonewho's going into healthcare,
(28:47):
exactly like you were saying,know your lane, be really,
really, really good at yourlane, and let everything else
go, or you're gonna driveyourself absolutely crazy.
Ashley Love (28:55):
One of the things I care most about with Shadow Me
Next is helping students preparefor their own pre-health
interviews.
So in every episode, we includea quality question, not to test
you, but to help you practicereflecting, communicating, and
showing who you are.
Jesse Bayer reminds us thatsome of the most important work
in medicine happens in 10 to 60minutes.
(29:18):
Not in long-term plans, not inperfect outcomes, not in tidy
stories, in the moment, inchaos, in space between crisis
and safety.
If you're a pre-health student,ask yourself, can I stay calm
when others can't?
Can I listen without fixing?
Can I sit in discomfort?
(29:40):
Can I be present withoutcontrol?
This is the side of medicinethat shadowing shows us.
The real side.
Keep in mind that there's moreinterview preps, such as mock
interviews and personalstatement review, over on
shadowmext.com.
There you'll find amazingresources to help you as you
prepare to answer your ownquality questions.
(30:01):
I love that.
That is just like, oh, can welike paint that in glowing gold
letters and just plaster iteverywhere?
It would be incredible.
Um, okay, let's shift just alittle bit because I would like
to talk a little bit more aboutmental health and the grand
scheme of things in medicine asa whole.
Um, in your opinion, how hasembedding the mental health
(30:23):
clinicians that you see that youwork with that you are in the
first responder systems?
So this is, you know, coming inwith police officers, mainly
police officers, firefighters aswell, changed outcomes.
How have you seen it improvethe lives of these clients that
you're seeing?
Jessi Beyer (30:40):
It's been revolutionary.
Um, and I want to start thisconversation by saying that I
love my law enforcementpartners.
Like, I think the absoluteworld of them.
I am so lucky to work withthem.
Um, I really just every day Iwalk into work and I'm like, I
love you guys.
And like, shut up, Jesse.
I was like, I know, but I loveyou guys.
So we we have an amazing,amazing relationship.
Um, but this integration ofmental health into law
(31:02):
enforcement is beneficial for abunch of different ways and
reasons.
First and foremost, no one,very few people at least, go
into law enforcement wanting todeal with people in mental
health crisis.
They go in for the burglariesand the fights and the shootings
and all these different things.
Um, generalization, right?
Of course, there's there'sdifferent folks in different
places, but they don't go intoit to talk to the suicidal
(31:23):
person for three hours.
And so for me to come in andsay, hey, you don't want to do
that?
I want to do that.
Perfect, right?
Let's do that trade-off there.
Um, it allows me to take alittle bit more time, have a
little bit more understanding.
Um, and then also bringing thatadditional knowledge.
Cops, especially in the US, aretasked with so many things that
(31:44):
is not actually part of theirjob description.
They are the dumpsters ofhumanity.
And I mean that in the bestpossible way in that when people
don't know what to do withsomething, they have law
enforcement handle it.
And so they have such a widebreadth of responsibility and
things that they do and areinvolved in and are, you know,
responsible for that are notreally law enforcement and they
(32:04):
don't have the adequate trainingfor that.
I mean, yes, a lot ofdepartments go through maybe 40
hours of mental health-relatedtraining.
That's amazing.
I love it.
I have two graduate degrees inthe space.
Like there's just a differentlevel of education there.
Just like I have no idea whatI'm doing when it comes to um
writing a warrant or arrestingsomeone.
Like, I don't know, differentlanes, right?
And so me being able to bringthat additional expertise,
(32:28):
communicate with them of like,hey, this person isn't trying to
be combative right now.
They're actually experiencingchart of dyskinesia and blah,
blah, blah, blah, blah.
And like explain what's goingon to them can change the
outcomes of that.
Um, and then additionally,having the knowledge of those
different resources, like theywill just call me and be like, I
don't know what to do with thisperson.
What do I do with them?
And I was like, okay, great.
Well, you can send them hereand here's a referral and here's
(32:48):
a phone number for this.
Taking that responsibility ofhaving those additional
resources upon myself means thata law enforcement doesn't have
to.
But then also the clients havekind of this one-stop shop of
where they can get referrals todifferent places.
The other thing that I'll sayis that a lot of times the
addition of a mental healthprofessional or the addition of
a crisis negotiator on a SWATcall reduces the use of force.
(33:11):
Um, and I have looked forstudies to back up the numbers
on this and they don't exist,but this is just me speaking
experientially.
There have been a lot of callswhere if I was not there and I
was not able to talk the personinto the ambulance or one of my
negotiators was not able to talkthe person out of the house,
there would have been forceused, there would have been gas
bombs thrown in the house, therewould have been, you know, all
(33:32):
these different things thatmaybe would have escalated that
situation.
But because we come with adifferent perspective and a
different personality and adifferent base of knowledge,
those outcomes are potentiallydifferent.
Not all the time, doesn'talways work.
Um, but in terms ofnegotiations, at least the the
statistic out there is like ifwe can get on the phone with
them, about 80% of the timewe're able to negotiate them out
(33:53):
instead of having to use force.
So there's that element to itas well.
Um, very rambling answer, butthose are some of the benefits
of um implementing mentalhealth.
Ashley Love (34:01):
Not rambling at all.
No, that was that wasfantastic.
Great examples as well.
And I would imagine, you know,we we were TV is not real life,
and we watch all the SWAT showsand we see them busting into
houses and they're like soexcited about it and they love
it so much.
And I would imagine there aresome people that do love that.
However, I would also imaginethat most of them are thrilled
to have you so that they don'thave to do that, so that they
(34:24):
don't have to traumatize thisperson where they're not out to
traumatize people, right?
Jessi Beyer (34:29):
No, absolutely not.
Just a note on TV before Iactually respond to that.
Um, I love the show CriminalMinds.
I watched Criminal Minds likereligiously when I was a kid.
Um, it makes me so angrybecause everything that they do
negotiation-wise in that show islike wildly inaccurate.
And I'm like, no, no, we wouldnever do that.
That doesn't work that way.
So, yes, not real life.
Um, in terms of your actualpoint here, it's very, very
(34:53):
true.
There are 100% people that arelike, hell yeah, I want to go
boot down the door.
We have moments of hell yeah,I'd like to go boot down the
door as a mental healthprofessional.
Like, we all have those momentsof, yeah, we want to get in
there, we want to go after it.
Um, but there's also timeswhere they don't.
Um, and for example, we had aclient one time, 400-pound
trained MMA fighter, flurriedlypsychotic.
(35:13):
Um, and there was a warrant outfor his arrest.
And so I call him, and thefirst thing he says is, like,
what do you want?
If any cops come to my door,I'm gonna fight him.
And he had a history offighting law enforcement.
And I ended up talking him outof the house.
It was peaceful, he gotarrested, it was all good.
But I was talking to mysergeant afterwards, who's on
the SWAT team, and he was like,I am so glad you were here
because I did not want to get inthat fight.
(35:34):
And I knew that if we got intothat fight, he was going to the
hospital and we were probablygoing to the hospital too.
And so there very much is thatperspective of, yes, okay, harm
reduction is amazing, but I amliterally preventing sometimes
my deputies and my clients fromgetting punched in the face.
Um, and that feels really good,like to be able to have that
influence and just keep thephysical safety of people safe
(35:56):
as well.
Ashley Love (35:56):
Which is incredible too, because this is a very
much of a side note, but yourhobbies are incredibly physical
and very, very tough.
So, you know, I I couldprobably bet on you against a
400-pound MMA fighter.
I feel like you could probablytake them, even if you wanted
to.
But again, that that is anaside.
We do not have to go there.
But definitely check outJessie's Instagram and some of
the really, really cool thingsthat she's doing there.
Let's talk directly to ourclinicians now and our future
(36:18):
clinicians.
What do you wish that everyfuture clinician or current
clinician understood aboutsuicide risk that we are
missing?
Jessi Beyer (36:29):
Yes.
This is where I get on mysoapbox.
In specifically primary care,um, about 75% of people that die
by suicide have seen theirprimary care physician in the
year before they died.
And in most primary caresettings, there is no screening.
There's no discussion.
At most on an intake checklist,there is a have you experienced
(36:50):
thoughts of harming yourself orothers?
Yes or no.
And then that's kind of the endof the discussion.
Primary care physicians,clinicians in general, and I'm
I'm almost intentionallyexcluding emergency clinicians
here because they get this allthe time, like that's a pretty
common part of their life.
But like everyone else, you arein a prime situation to screen
for patients that areexperiencing suicidal ideation,
(37:13):
to do risk assessments, to doreferrals, and to literally save
these people's lives just byasking a few questions.
And that is what I getincredibly passionate about when
talking to healthcare teamsbecause they're like, oh, you
know, I'm I'm a dentist, right?
Or I'm primary care or I'm anOBGYN, like whatever.
I'm not dealing with people incrisis.
And what I tell them is thatyes, you are.
(37:34):
You just don't know that yourpeople are in crisis.
Or they're presenting with somesort of somatic symptom that
is, you know, a chronic stomachache or chronic headache or um
their acne has flared up out ofthe blue or whatever that is.
Putting those pieces togetherand understanding not to get
like too woo with it, but likethe mind-body connection and the
fact that what's going onupstairs is going to be
(37:54):
reflected in the rest of thebody, recognizing that,
understanding that, and takingthe five minutes to sit down
with your patient and say, Hey,what are you doing?
Like just tell me about yourlife.
I I hear that you're here for astomachache, but what else is
going on for you?
No one does that.
No one does that.
And so taking that time, theymight say, Oh, yeah, you know,
it's okay.
You know, you know, work'sbeen, you know, up and down
(38:16):
lately, but all in all thingsare good.
Okay, you know, up and down.
What do you mean by that?
What's been going on there?
Oh, well, you know, um,actually, I I just got fired
recently.
Okay, now we're gettingsomewhere, right?
Now we're digging in and we'rehaving this conversation and
you're learning things aboutyour patients that you wouldn't
if you just had that intakecheckbox, do you want to die or
not, type of thing.
So you are you as a clinician,right?
You are at this criticaljuncture where you can intervene
(38:39):
in your patients' lives in waysthat you probably don't think
you can, and that statisticallyyou absolutely need to.
Ashley Love (38:46):
You're right.
And it's it does take a minute.
And I think that as clinicians,we hear that and we think,
well, I only have 20 minutestimes 30 appointments throughout
the day.
But every each of those 30appointments, you're not going
to be having this conversation,right?
I mean, this is something thatmaybe you pick up um a handful
of times and you address it, andmost people will just blow you
(39:06):
off, or there's actually nothingwrong.
But that one person that thereis, and that one person that you
really get to tap into.
Um, there's this happened to mein clinic, and I am in
dermatology.
So very much in that wholerealm of things, we had a
patient come in.
She was very hesitant todisrobe, to take her clothes
off, which is kind of part ofder if we, if you're there for
us to look at your skin, we haveto be able to see your skin.
(39:28):
Um, extremely hesitant, thepoint where my medical assistant
came, got me, and said, Hey,listen, I don't think we're
gonna be able to do this, etcetera.
I walked in just so that shecould meet me, even if we
weren't doing a skin check thatday.
Recognized something, I don'tknow, a little that spidey
sense, right?
Um, and we dove into it alittle bit.
She's a sexual assaultsurvivor, literally within the
(39:52):
last number of weeks, but shedidn't want to cancel the
appointment because she's tryingto normalize her life, which I
was so proud of her for doing,et cetera.
Um We didn't take her clothesoff at that appointment.
We sat there and I had a20-minute appointment slot.
So we talked for 20 minutes,right?
And then I said, Hey, whenyou're ready, I would love for
you to come back in.
How can we make thiscomfortable for you?
How can we make thisappropriate for you so that I
(40:13):
can check the areas of your skinthat you want me to check?
Um, and we did, and you knowwhat?
Every single time she comes in,she brings a gift, which is so
sweet.
She does not have to do that.
But I'm just so gratefulbecause um, you know, first of
all, she has gorgeous skin, soshe doesn't need to be there to
see me, but I'd like to thinkthat that positive experience is
hopefully going to fuel otherpositive experiences for her in
(40:34):
healthcare to where she can goback to see her GYN and she can
get those routine exams and shecan see her male PCP.
Um, so it, like you said, youknow, sometimes it just takes
that one brief, brief moment.
And uh it's it's one of myabsolute most favorite stories
in healthcare.
And it started off withsomething so miserably painfully
sad and a terrible conversationthat I had to have with the
patient.
But um, what a greatrelationship it is now, you
(40:57):
know, it's really, really cool.
Jessi Beyer (40:58):
That's amazing.
And I know that you are not theone being interviewed, Ashley,
but like that story just oh mygosh.
I mean, it warms my heart somuch.
It's obviously terrible andtraumatic and it makes me sad at
the same time.
But knowing that there areproviders like you out there
that took that time, that sawthat warning sign and did
something with it, like justgives me so much hope.
Um, and I'm not overstatingthis, like I'm saying this as
(41:20):
someone who sees crisis everysingle day, sees sexual assault
survivors every single day.
Um, you may have saved herlife.
At the very least, you changedthe trajectory of her life
dramatically.
Um and her life could havetaken a very, very different
turn if she didn't have those 20minutes with you.
And so for everyone who'slistening, who's considering
going into healthcare, who'salready in healthcare, obviously
(41:41):
you want to help people, youwant to make a difference in
people's lives.
But maybe you're in a fieldwhere you're like, I don't save
lives, you know, like I helppeople, but I'm not saving lives
in this profession.
You are, and you can.
You just have to take those fewminutes and have that
conversation and invest thattime in someone who, yeah, came
for her skin, but she needed anear and a shoulder and someone
(42:03):
to be there with her.
And you gave her that.
And that's amazing.
And it makes me very happy.
Ashley Love (42:07):
I like yeah, I never even thought of it that
way, Jesse.
But you're you're right.
I mean, you're right.
Obviously, this is this is whatyou do.
You're absolutely right.
And um, you know, to me it wasjust 20 minutes, but who knows
what it was, uh, what it was forher.
Oh my gosh.
Before we really wrap up, ifthis conversation is just really
influencing you and you youwant to know more, I would
highly recommend you pick upJesse's book.
It's called How to Heal (42:28):
A Practical Guide to Nine Natural
Therapies You Can Use to ReleaseYour Trauma.
And this is amazing because itsounds like it was written for
trauma survivors, for people whohave experienced trauma.
But I will tell you, as aclinician, this book is
invaluable because I'm going tobe, I have, as I've mentioned,
talked to these people.
And having some of these toolsthat you've talked about, things
(42:50):
like eye movementdesensitization, um, dance
movement therapy, canineassisted therapy, which of
course, knowing your backgroundand as a maybe veterinary
medicine practitioner at onepoint, this makes a lot of
sense.
Equine, of course, as well.
Um, uh, ecotherapy andnature-based therapies.
These things are amazing.
And just would give people somuch hope to, you know, like I
(43:12):
said, to come to yourdermatologist and have your
dermatologist talking aboutdifferent therapies that they've
learned from you.
Um and uh just tell us a littlebit about this book, who it was
written for, and uh, and whatyou hope to do with it.
Jessi Beyer (43:26):
Yeah, so this book was a passion project for me,
and it really was born out of myown experience, like I
mentioned, thinking that Ieither could go to talk therapy
or I had nothing, and I had tokind of figure it out by myself.
Um, and I realized that thatwasn't the case.
There are other modalities outthere.
And so this is really writtenfor the person who has tried the
traditional trauma therapiesand they haven't worked for
(43:47):
them, and I will go into that injust a second.
Or for the people who don'twant to try, they're
uncomfortable with that for somereason.
There's some part of theirstory that doesn't align with
that, and they're looking forsomething else.
Um, so these are allwonderfully rich methods of
healing from trauma, body-based,movement-based, nature,
animals, all these differentthings, very holistic methods of
healing from trauma that arealso empirically supported.
(44:09):
Because I'm as much of a datanerd as I am like this woo-boo
fluffy, hug a dog and feelbetter type of person.
Um, so they're really wonderfulmodalities there.
In terms of kind of traditionaltrauma treatment, when I
reference that, uh, the AmericanPsychological Association
recommends a few talk-basedtherapies and then some
medications for traumatreatment.
So we're looking at cognitivebehavioral therapy, we're
(44:30):
looking at exposure therapy.
Um, those are kind of the twobiggest ones, and then your
combination of SSRIs and SNRIsfor medication-based trauma
treatment.
Um, and the APA, the AmericanPsychological Association, likes
to kind of tout these as thegold standard and everything
else is subpar.
And if you really dive into theliterature on these different
modalities, depending on thestudy, it's about 50% of people
(44:54):
that achieve benefit from thosetherapies.
And then if you get evenfurther into that, you have to
determine whether benefit meansa clinically or I'm sorry, a
statistically significantreduction in clinical symptoms
or a reduction in symptoms to alevel below the diagnostic
criteria.
Because some of these studies,to simplify the diagnostics on
(45:14):
it, um let's say that you comein with 10 out of 10 on the
trauma scale, on the PTSD scale.
Um, and then the the baselinefor diagnosis is a five.
So you have to at least get afive to be diagnosed with PTSD,
but this person comes in with a10.
Well, they got down to an eightbecause of this treatment.
Yay, it's a huge success.
They still have PTSD.
Like they're still incrediblysymptomatic from this.
And so as you're reading thesestudies, you really have to get
(45:37):
into like what is considered asuccess?
Is it clinical remission or isit a significant reduction in
symptomology?
Both are good, but it it landsdifferently depending on what
you're looking at there.
So my point of that is there'sa lot of folks that are helped
by these therapies.
And I love those therapies forthose people.
There's also a very large chunkof people that are not.
And what happens in thisAmerican Psychological
(45:59):
Association-based world oftreatment that we live in is one
of two things.
The patient gets blamed.
So there's a lot of studies outthere that talk about, well,
patient noncompliance andpatient refusal to engage and
all these different things.
And my response to that is ifyour therapy is so traumatic
that no one wants to do it, itdoesn't work.
Like it's not good enough.
We need to amend that.
Um, so that that is one thingthat'll happen is the patient
(46:22):
will get blamed, or they will betold there's nothing else.
There's nothing else out therefor you.
You either have to do this oryou're on your own.
And so my book was reallycreated for that person who's
been in that experience to say,hey, it's not your only option.
There are other things outthere.
And it's very much written,human to human.
It's not clinical language.
It's me just blabbing like I amright now about all these
(46:43):
different modalities.
Um, so it's very approachable.
In a lot of them, I actuallywent to that therapy.
And so I talk about here is myexperience, here's what we did,
here's what it felt like, herewere the revelations that I went
through.
Um, and getting kind ofpersonal with some of that.
So people can maybe experiencea session before they actually
have to go themselves.
Um, and so yeah, I mean, that'sthat's my goal with it is
spread awareness, spread hope,and spread options for people
(47:06):
that are looking to heal, butdon't feel like the
traditionally presented optionsare gonna work for them.
Ashley Love (47:11):
Oh my God.
Awareness, hope, and options.
Could we want nothing more?
It's just a fantastic gift thatyou have given.
The book, again, is called Howto Heal: A Practical Guide to
Nine Natural Therapies You CanUse to Release Your Trauma.
It's available on Amazon.
Um, and if you guys have fallenin love with Jessie as much as
I have, please check her out onInstagram.
It's Jessie Bayer.
(47:32):
That's J-E-S-S-I-B-E-Y-E-R.
It's Jesse Bayer.
Um check her out on LinkedIn,same name.
And then, of course, on herwebsite, Jessie Bayer
International.com.
Jesse, thank you, thank you,thank you for the work that you
do.
I am so glad to know that thereare people like you out there
(47:53):
um meeting us in our deepest anddarkest moments.
And like you said, you are justthis small beacon of light.
Um, and thanks for joining uson Shadow Me Next and sharing
your story today.
Jessi Beyer (48:03):
Absolutely.
Thank you for having me.
And anyone who's listening, ifyou're curious about this field,
it is new-ish.
Like it's we're kind of on theforefront of it.
So if you have questions, ifyou're like, I'm curious about
it, I want to try it, I want tolearn more about it, like shoot
me a DM, shoot me an email.
I'm happy to just talk aboutwhat I do and help you figure
out if it's something thatyou're interested in as well.
Ashley Love (48:22):
Incredible.
Thank you so much, Jesse.
Thank you so very much forlistening to this episode of
Shadow Me Next.
If you liked this episode, orif you think it could be useful
for a friend, please subscribeand invite them to join us next
Monday.
As always, if you have anyquestions, let me know on
Facebook or Instagram.
Access you want, stories youneed, you're always invited to
(48:43):
Shadow Me Next.
Hello, and welcome to Shadow Me Next, a podcast
where I take you into and behindthe scenes of the medical world
to provide you with a deeperunderstanding of the human side
of medicine.
I'm Ashley, a physicianassistant, medical editor,
clinical preceptor, and thecreator of Shadow Me Next.
It is my pleasure to introduceyou to incredible members of the
(00:22):
healthcare field and uncovertheir unique stories, the joys
and challenges they face, andwhat drives them in their
careers.
It's access you want andstories you need.
Whether you're a pre-healthstudent or simply curious about
the healthcare field, I inviteyou to join me as we take a
conversational and personal lookinto the lives and minds of
(00:43):
leaders in medicine.
I don't want you to miss asingle one of these
conversations.
So make sure that you subscribeto this podcast, which will
automatically notify you whennew episodes are dropped.
And follow us on Instagram andFacebook at Shadow Me Next,
where we will review highlightsfrom this conversation and where
I'll give you sneak previews ofour upcoming guests.
(01:03):
Today's guest does work thatmost people never see and very
few people could actually do.
Jessie Bayer is a crisis mentalhealth clinician who responds
alongside law enforcement to 911calls involving suicidal
ideation, psychosis, and severesubstance use.
She's also a trained negotiatoron her SWAT team.
(01:25):
When situations are volatile,emotional, and dangerous, Jessie
is the mental healthprofessional in the room,
helping bring things down, keeppeople alive, and move them
toward safety.
Her path here is just aspowerful.
EMT training, a background inpsychology, graduate work and
(01:45):
trauma, crisis intervention,military psychology, and
terrorism studies.
Every piece of her story hasshaped the way she shows up in
moments that matter most.
In this episode, we talk aboutde-escalation, emotional
intelligence, knowing your rolein medicine, and what it really
means to be a steady presence inchaos.
(02:06):
Please keep in mind that thecontent of this podcast is
intended for informational andentertainment purposes only and
should not be considered asprofessional medical advice.
The views and opinionsexpressed in this podcast are
those of the host and guests anddo not necessarily reflect the
official policy or position ofany other agency, organization,
(02:27):
employer, or company.
This is Shadow Me Next withJesse Beyer.
Jesse, thank you so much forjoining us today on Shadow Me
Next.
I am thrilled to hear what youhave to say and the incredible
story you have to bring to ustoday.
Jessi Beyer (02:40):
Oh, well, thank you for having me.
I'm I'm super excited to talkabout it and figure out how we
ended up in this world that Icurrently work in.
So I'm super happy to be here.
Ashley Love (02:48):
Which is a really incredible world and one that is
um I, you know, I say this tolike our helicopter nurses and
our critical care physicians,that their their life is high
stress, high reward, but reallynothing holds a light to what
your high stress, high rewardsituation is, which of course
we're gonna break down.
But Jesse, we're gonna start atthe beginning here because you
(03:11):
gave me a little teaser and Ijust cannot wait to talk about
it.
Tell them how you ended up inthis field of medicine, is what
we're gonna call it, in thisfield of medicine that you are
experiencing right now.
Jessi Beyer (03:24):
Yeah, so this is definitely kind of a weird
story.
So going back even a little bitbefore the teaser that I gave
you, when I was in high school,um, my boyfriend at the time
attempted suicide.
And that was just a really,really difficult night for me.
I had been his big supportsystem.
I was the one who called 911 toprevent that attempt from being
(03:45):
completed.
And in kind of the aftermath ofthat, of course, law
enforcement shows up, he getstaken to the hospital.
Um, there was a social workerthat showed up with the cops as
well.
And she talked to me for alittle bit, you know, hey, are
you okay?
She gave me her card.
You know, if you need anything,you can reach out.
And I was like, that's cool.
And then promptly put herbusiness card in my bathroom
drawer and like didn't thinkabout it.
(04:05):
So there was this seed that wasplanted in my mind that I
really didn't think I could domuch with.
Um, and it just kind of satthere for a while.
And then when I decided I, youknow, wanted to go to college
and was figuring out what Iwanted to do, my freshman year
of college, I actually went toveterinary school at the
University of Edinburgh inScotland.
For context, I grew up inOregon.
So that was quite a departurefrom the world that I was used
(04:28):
to.
And I got there and I was like,well, this is not what I
thought it was gonna be.
It was um a bit of a moment ofbreaking the rose-colored
glasses of what I thoughtveterinary medicine was.
And what really crystallizedthat for me was recognizing that
the care stops when the moneyruns out or the animal is no
(04:49):
longer of value to the humans,not when the job is actually
done.
And for my personality, I'mvery much a like complete it at
all costs type of person.
And so that really, it was justlike this whole moral thing of
I don't think I can do this forthe rest of my life.
I don't even think I can dothis for the rest of the
five-year degree program.
So I was like, I need to getout.
I need something where um I canjust I it's it's me and the
(05:13):
patient, and I can complete thisjob.
And so I went to Canada and Igot my EMT license.
And I was like, I'm gonna gointo emergency medicine because
it's just me and the patient andthe back of an ambulance, and
my job is to keep them alive.
There's no politics involved.
Anyone who works as an EMTknows that there are tons of
politics in EMS, but my likenaive self thought that that's
what I was gonna do.
Um, and I loved it.
(05:33):
Like that EMT course that Itook was one of my favorite
educational experiences thatI've ever had in my life.
I just absolutely loved it.
So I was like, okay, I'm gonnastay in Canada, I'm gonna get my
paramedics license, I'm justgonna work in emergency
medicine, it's gonna be great.
And uh my parents were like,yeah, but babe, you need a
college degree.
Like you, you have to go tocollege.
And I was like, but do I?
(05:54):
And they're like, yes.
And so I was like, fine.
So I went back to the States umand I finished my degree in
psychology at the University ofMinnesota.
It was a bit of a protestdegree, I will say.
I was kind of like, I don'treally want to be here.
I don't know what I want to do,but psych is somewhat
interesting to me.
And so what the heck, I'll goahead and do it.
And my uh one of my electiveclasses, my senior year, maybe
(06:18):
my junior year, one of my lasttwo years, um, was on
nature-based therapies.
And that really turned the tidefor me because that piqued this
interest for me.
Um, back after my high schoolboyfriend had attempted suicide,
I went to one day of therapy umafter that.
And it was just, it wastraditional talk therapy, like
nothing crazy.
I hated it.
I was so uncomfortable.
(06:38):
I literally ran out of thebuilding, like full on running
out of the building.
Um, and I never went back.
And I thought that that was myoption, was like talk therapy or
bust, essentially, as I wastrying to heal from this.
And so learning that there werethese other modalities that are
out there, there's other waysto heal from traumatic events.
That really got me backinterested in the world of
psychology.
So ended up finishing thatdegree.
(07:00):
My capstone was on differentintegrative trauma therapies,
movement-based, nature-based,animal-assisted, all these
different things.
Um, and then I just startedspeaking and talking.
And I did a lot of work ineducation, peer support
education, um, integrativetherapy education for a number
of years until I landed in thespace that I landed in now, um,
which, as we talked about in theintro, I do crisis mental
(07:22):
health work alongside lawenforcement.
I'm a negotiator on our SWATteam.
Um, and another littlebreadcrumb for this is after I
graduated college, undergrad,uh, before I went to grad
school, I um I did a ride alongwith our local deputy and his
mental health professionalpartner.
And we went to a call where itwas a domestic violence
situation and they ended uphaving a negotiator come out.
And I remember sitting in theback of this patrol car and I'm
(07:44):
like, hey, that's kind of cool.
Like, could I ever do that?
And they're like, no, you haveto be a cop to be a negotiator.
And I was like, oh, okay.
And again, filed it in thebathroom drawer kind of thing.
Um, and ended up being anegotiator, not being a cop.
So it's interesting how thisworld comes together.
Um, and I guess I in thatprocess, I skipped over grad
school, which is prettyimportant.
Um, for me, I took a couple ofyears between undergrad and grad
(08:07):
school.
Um, I really am glad that I didthat.
I was told, you know, if youstop school, you're never gonna
go back.
And I have learned through myown experience and through the
experience of a lot of myfriends that that is not the
case.
Um, so I took a couple of yearsand then I went to grad school
for critical psychology andhuman services.
Um, and I focused a lot of myeducation on trauma and crisis
(08:28):
intervention.
So I got to design some of myown courses.
For example, I took a course onPTSD in military and first
responder populations.
I took a course entirely onsexual assault, which sounds
like very heavy and traumatic,but was just wildly interesting
to delve into all the differentelements of that.
Um, so really amazingeducational experience.
Um took another couple of yearsoff and then went back and got
(08:51):
a second master's in militarypsychology with a focus in
terrorism.
Um, and all of these like weirdeducational things that I've
done over my life have set me upreally well for the work that I
do now and given me a veryunique perspective to bring to
the table.
Um, so yeah, in like a verylong nutshell, that is my my
journey to where I am today.
Ashley Love (09:11):
It's such a cool journey, and I love it because
um, even just speaking with youbriefly for a couple of minutes,
all of a sudden, all of thesedifferent elements, all of these
different pieces of your lifehave really beautifully just
combined into this perfect rolefor you, really.
And you mentioned a couple ofthings, and I'm so glad that you
brought them up.
First of all, um, you just litup when you talked about your
(09:32):
time as an EMT in Canada.
And and I love to hear thatbecause I think so often people
think of their role as an EMT umas being perhaps a stepping
stone to something else.
Like so, for example, I'm a PA,I'm a physician assistant, and
we um a lot of students will gettheir patient contact hours as
EMTs.
And speaking with so many of mycolleagues, they say, Ashley, I
(09:53):
almost did not go to PA schoolafter this because I enjoyed
being an EMT so much.
Um, so I'm so glad you broughtthat up.
It's such a fantastic career,and I would imagine really,
really, really sets you up forthe work that you do right now,
communicating um with some ofthe different people, law
enforcement agencies, firedepartments, SWAT.
Um, it's a whole differentlingo, right?
(10:14):
And you speak it, I wouldimagine, largely because of some
of the stuff you encountered asan EMT.
Jessi Beyer (10:19):
Yeah, absolutely.
It's it's a wonderful,wonderful career.
Um, and through my work as anEMT, I got to do a lot of like
sports events and youth sportsevents, which being a child
athlete myself, I was like, socool.
I'm back in basketball land.
Um, so that was really fun.
And then I also did work as anEMT with search and rescue.
So now we're talking likebackcountry, austere, like
things are breaking and we haveto fix it with a stick kind of
(10:40):
thing.
Um, hopefully that's why I'mthere as I bring more stuff.
But it's that type ofenvironment.
Um, and just all these amazingexperiences.
And so for any of yourlisteners, any of your audience
that is considering emergencymedicine as a path, I will say
now I love working with EMTs inthe role that I have now because
they're often the ones that lawenforcement and I show up
(11:00):
first.
We do safety checks, immediatede-escalation, whatever that is.
And then if the person needs toget transported to the
hospital, I'm not driving them.
The cop isn't driving them.
It's an EMT crew that comes andtakes them.
So being able to hand off tothem, not only speak their
language to have thatprofessional relationship, but
also that empathetic touch thatthat EMT brings because they
(11:21):
have that ride into the hospitalto just chit-chat with that
person.
Like there's no medicalintervention necessarily that
needs to be done.
But if you're thinking about acareer in emergency medicine,
it's not just I'm treating heartattacks and I'm treating broken
bones.
It's I'm talking to a kid thatwants to kill themselves, or I'm
running around with a searchand rescue dog trying to find
(11:42):
someone lost in the middle ofthe woods.
Like there's so many differentelements to that career field.
Um, and whether it's a steppingstone or a permanent place,
like I think it's a wonderfulentry into medicine.
Ashley Love (11:52):
No, I totally agree.
It is a fantastic opportunityto really see humanity,
unfortunately, at its mostsignificantly painful moments,
which we're gonna talk a lotabout here in just a couple of
minutes.
But before we get too far intothat, let's talk about your role
because I think I think it isjust so interesting.
(12:14):
So you really you sit at thiscrossroads, right, of medicine,
of mental health, and of publicsafety, which I think is is such
a cool and unique place for youto be.
Tell us what you do when you goon scene with law enforcement
or fire rescue, when when youshow up in the morning, what
does your job look like?
Jessi Beyer (12:34):
Yeah.
Well, I will specify that Idon't show up in the morning, I
show up at night.
Um, so I work, I work swingshift, um, which is two to
midnight.
And uh the reason that Ihighlight that is for a number
of different reasons.
But one is that's when a lot ofcrises happen.
And so if you're working in anysort of first response or
emergency health care, might notbe a nine to five.
(12:55):
So just kind of prepareyourself for that.
Um, and the other thing is thatoftentimes I'm the only mental
health resource that's availableat that time.
Private practice is closed,substance use disorder treatment
centers are closed.
It's kind of just me.
And so I frame that beforegoing into like what I actually
do.
So I respond alongside mostlylaw enforcement, sometimes EMS,
(13:16):
sometimes both, um, to 911 callsthat have some sort of
behavioral health element.
And the three most common onesfor me are suicidal ideation,
psychosis, and substance usechallenges, andor a
conglomeration of multiple ofthose.
When I show up on scene, myrole is twofold.
One is the immediatede-escalation.
So we've had folks that haveknives, we have folks that are
(13:40):
screaming bloody murder, we havefolks running down the middle
of the highway at two in themorning.
How do we take this from level10 to like maybe a level three
or four where we can actuallyhave a conversation about next
steps?
Part two of my role is what arethose next steps?
I will always tell people Iwould be a terrible private
practice therapist.
Um, God bless people that dothat, but that is not me.
(14:01):
I love the immediate work andthen passing them off to someone
else for longer-term care.
And so part of my role is thatpass-off, right?
What resources are available?
Um, where can we put you ortake you or connect you with so
that you don't continue havingthese crises?
How can we reduce the alliancewith the reliance on the 911
system on hospitalization, lookat community-based care?
(14:23):
And that really spanseverything from securing bus
tickets for people, like buspasses, um, housing, treatment
for mental health, for physicalhealth, for substance use
disorders.
Um, we have a specific resourcein our county for um temporary
fostering of pets while peoplego to detox.
And so it's this interestingworld of knowing all of these
(14:44):
different resources, knowing whohas a wait list, who doesn't,
how do you access it, what arethe access criteria and
admission criteria, and kind ofcrafting this plan with the
client of, okay, great, we fixedthe immediate crisis.
We're no longer screaming.
What do we do now?
Where do we take you next?
And so that is just as much apart of my job as that immediate
de-escalation risk assessmenttype stuff that I do.
Ashley Love (15:05):
That is so cool.
Thank you for breaking thatdown so well for us.
I think there's a couple ofways I want to go with this.
Number one, immediatede-escalation.
I'm like, I'm having flashbacksto moments of like the last
three days with my children,really, because there's so many
times I've said, is this acrisis?
Are we in crisis right now?
And they've said no.
I'm like, well, they'rerescreen.
Let's please calm down.
(15:25):
But um, the immediatede-escalation, I would love to
hear some of the tools that youuse for that, right?
And and this is number one,this is for your role because
obviously you use this everyday.
I in dermatology, I am notchasing people down a highway,
usually.
However, there are definitelymoments when I realize I've
walked into a situation that'svery, very hot, very, very tense
(15:46):
for whatever reason.
Now it's not as typically asdangerous as your situations,
but knowing some of these toolsfor de-escalation, especially in
healthcare, is super importantto get to the point quickly with
some of these patients.
Say, what are um, tell us afew, if you can, some of these
tools that you use.
Jessi Beyer (16:02):
Absolutely.
I'll ground this in a scenariothat happened a couple months
ago, perhaps.
I took a client to thehospital.
She had been endorsing suicidalideation.
She wasn't willing to do asafety plan and stay at home.
So we're like, okay, we'regoing to the hospital.
Um, and this particularclient's story, she had a very
difficult sexual relationshipwith her husband, a lot of
coercion, a lot of obligatoryinteractions there, just very
(16:24):
not healthy, lots of traumabackground going on there.
And so we're in this hospitalroom, and the nurse comes in and
is like, okay, I need to drawyour blood.
And she's like, No, you don't.
Why do you need to draw myblood right now?
And they started kind of goingback and forth at that.
And the nurse just got stuck inthis cycle of, well, I
understand what you're goingthrough.
And the client was like, No,you don't.
(16:44):
You have no idea what I'm goingthrough.
No, trust me, I do.
I've seen a lot of people inyour position, yeah, but you
don't understand what I'm goingthrough and just button heads.
And I was standing in the roomand I could just feel the
tension in everyone just startgoing up.
Um, and I think that thathappens a lot because as
healthcare workers, especiallyin the emergency department, you
kind of have seen it all.
(17:05):
Like you've probably seenpeople in very similar
situations to this woman'ssituation.
And so in your mind, you'relike, no, I I get it.
Like I've seen people in yoursituation before, but in that
client's mind, they're like, no,you haven't.
You don't know my story, youdon't know my situation, you
don't know what's going on withme.
And so I say all of that tohighlight the point that the
biggest thing that you can do interms of de-escalation is set
(17:27):
aside yourself, set aside whatyou've seen, your experience,
your perception of this client,and sit with that person in
their moment of pain.
So that can kind of take one oftwo ways.
If you have a very sad,depressed, crying that type of
person, it's going to be calmer.
You know, this is more of myclient voice when I'm talking
with someone who's in that typeof emotional state and it's very
(17:50):
validating and labelingemotions.
And yeah, I mean, it soundslike you're really, really going
through a hard divorce rightnow.
Like whatever that is, right?
It's getting on their level.
It's that calm type ofreflecting the emotions that
they're sharing with you.
If you have someone who'scoming in and they're screaming
and they're mad and they'rethis, I'm gonna reflect that a
little bit.
It's gonna be more, yeah, dude.
I get it.
Like you were out there, youwere just minding your own
(18:12):
business, and then all of asudden you're hog tied and
brought to the hospital.
I'm doing the same skill ofreflecting the emotion of I
don't want to be here.
I brought, I was brought hereagainst my will.
I'm frustrated, I'm mad, I'mwhatever.
But I'm matching that a littlebit and then slowly working my
way back down.
Sometimes it works if you cancome in with a really, really
escalated person and you arelike barely, barely speaking,
(18:34):
because then they're like, Ican't hear you, and then they
bring themselves downimmediately as well.
But sitting with them in thatspace sometimes means you're mad
with them.
And so if you can bringyourself to that level, have
that conversation.
Usually what happens with folksthat are really, really
escalated is if you can get onereally good reflection in there.
So one sentence of, yeah, itsounds like you were minding
(18:55):
your own business and then allof a sudden all these cops
showed up, or yeah, it soundslike you were having a really
difficult fight with your wife,and then she threw in this
really hard insult or whatever.
I don't know, whatever it is.
If you can get one really goodone of those in there, they will
go from a 10 to a six almostinstantaneously.
Um, and one story for this,just to put a more a little bit
more color to it, we were out ona SWAT call, I think it was
(19:17):
like three in the morning.
Um, and this kid, he was about10 years old.
He had just watched his fathershoot his grandfather.
Um, and he got drug out of bedby law enforcement to get him
out of the house to get him tosafety.
Um, and so I'm talking with himand he's pacing, he's talking a
million miles an hour.
He's talking about like threelevels of volume louder than he
(19:38):
needs to be, and just going onabout how disappointed he is in
his dad and how his dad hasn'tbeen there for birthdays and
hasn't done this and hasn't donethat and all these different
things.
And he just was like at hisdad.
And I said to him, I was like,Hey, it sounds like you've been
looking for more from your dadfor a really long time.
And he was like, Yeah, and isfull possible.
(19:59):
Changed.
He sat down on the curb.
He lowered his volume.
He slowed his speech.
And so just that one line, Iwas even sitting there being
like, that worked better than Ithought it was going to work.
Like I shocked myself with howthat line worked.
It's not always that easy.
But my point is, if you can getthat one, one good reflection,
one moment of rapport, that isoften enough to take a really
(20:21):
escalated person down a fewnotches and then as a provider,
help ensure your safety in thatsituation as well.
Ashley Love (20:27):
Absolutely.
It's reading between the linesand it's so much easier said
than done.
I like to call it the hiddengem in clinic.
And sometimes it's somethingthat they say offhanded as an
aside that if you can recognizeit, if you can pick it up, um,
and just try to scooch it in aswell.
(20:48):
I mean, you can't attack it.
You cannot attack these things.
But if you just kind of easeinto it, like you mentioned, I
heard you say X, Y, and Z.
And oh, by the way, this onetoo, they feel heard, they feel
understood.
And like you said, it canabsolutely de-escalate a
situation.
Um, or even and even if theyare already calm and collected,
but maybe withdrawn and notsharing, sometimes it can help
(21:11):
open them up as well.
So, oh, thank you so much forsharing those.
Those are really, really goodexamples.
I love it.
And something that before Imove on that I want to um that I
want to touch on real quick,you mentioned that most of the
calls that you are that you'rethat you go to um late at night
are suicidal, suicidal ideation,psychosis, and substance use.
But then you just mentioned a10-year-old.
(21:32):
Do you see adults and childrenthen?
Are you involved in both?
Jessi Beyer (21:36):
Yes.
So the youngest client thatI've ever had was six, and the
oldest was late 80s, early 90s,I think, somewhere in that about
to go into the nursing hometype of age range.
Um, so yeah, I I respond toeverything.
Um, anything that touches the911 system.
Um, we have a lot of parentsthat call in on their kids
because the the we have it'sfunny, I'm gonna say this, and
(21:59):
for me, this is like, oh, thisis a Tuesday, and it's gonna
sound wild to anyone who is nota part of my world.
Um, we have a kid who hisparents call 911 on him a lot
because he continually tries tokill his dad with a knife.
Um, and so we're figuring outhow to navigate that situation.
So we have that side of things.
Um, we have a lot of folks thatcall in on loved ones who have
endorsed suicidal radiation insome capacity.
(22:21):
So husband sent me a textsaying goodbye for real, or
daughter posted a bottle ofpills on Snapchat.
We get a lot of those.
Um, and then we get a lot ofconcerned citizen calls for the
person who's running down thehighway at two in the morning or
different things like that.
So it is a very, very widegroup of people that I work
with.
Ashley Love (22:39):
Which I think is really interesting.
And because there's certainelements of medicine, as you can
imagine, that are very, veryfocused when it comes to who you
see and what you do.
Um, and this career sounds likeit's very broad, which I think
to some people, uh, to a lot ofpeople would be quite
interesting.
Um, you mentioned a couple ofthings that I think are really
hot in media right now, and thatis recognizing some of these
(23:02):
signs that we're seeing ofsuicidal ideation, primarily
self-harm, things like that,which this is something that you
see all the time, all day,every day.
And um, of course, we want wewant people to report this.
Any little thing, it isabsolutely worth checking up on.
Um, let's keep each other safe,the whole, the whole nine
yards.
(23:22):
What does success for you looklike in crisis negotiation, even
when sometimes the outcomesmaybe aren't perfect?
Speaker 1 (23:31):
That is an amazing question.
Like, wow, first of all,awesome.
I love that question.
For me, um the first thing thatcomes to mind, and this is
maybe a bit um simplistic, butit's keeping them alive.
And the reason that I I saythat, and everyone's like, oh,
it's healthcare, of course.
Our goal is to keep them alive,but there's a lot of commentary
(23:54):
in the media right now aboutwell, law enforcement just
arrests people that have mentalhealth challenges and we just
take them to jail, and there'sall these things that are you
know wrong with that.
And I agree, jail is not theideal situation for folks,
right?
That's not the ideal healingscenario.
But when intensive outpatienthas wait lists a mile long, when
(24:15):
inpatient is full and there'sno beds available, I can't get
someone well if they are notalive.
And so if that means thatthey're going to the hospital or
they're going to jail, that's awin.
I would say that my, you know,ideal situation is this um, you
know, terribly depressedteenager that I speak with, and
(24:36):
then we make this amazing safetyplan, and then they're
de-escalated and they get tostay at home and they go to
school the next day, and youknow, they email me six months
later and they tell me thatthey're doing amazingly.
I've had those.
I had this one kiddo that Itook her to the hospital dozens
of times, sponsoring these forceon her dozens of times to get
her to the hospital.
(24:56):
Um, just chronic, chronicsuicidal ideation.
And I was given her parentslike resources last grade and
center.
I could not figure out what todo with this kiddo.
And then she just dropped offthe face of the earth for like
six months.
And I was talking with my lawenforcement partners, and
they're like, Yeah, we haven'theard from her either.
And I was like, Well, she'seither better or she's dead, and
I don't know which.
Um, and I I heard from mydeputy a couple months after
(25:19):
that.
He's like, Hey, I ran into herin a coffee shop.
And I was like, And he's like,Yeah, she's doing amazing.
Like she went to inpatienttreatment down in California for
a couple months.
She got a job, she is trainingher service dog.
Like, she's doing so well.
And she told me to tell youthank you.
And this client emails me everycouple months.
I get a little email on myinbox that's like update.
And then she tells me some newthings that are going on in her
(25:41):
life.
So those are like amazing wins.
And I love those and I cherishthose.
And when I don't have goodcalls, those are the ones that I
go back to of like, no, you'restill good at your job.
It's okay, you still helppeople.
Um, but at the end of the day,it is keeping them alive enough
to get them to a longer-termresource, is really what success
looks like in my role in someof these complex situations.
Ashley Love (26:01):
Thank you for that answer.
It is, like you said, it seemslike a very simplistic idea.
But you're right.
And a lot of people might notview that as an ideal success.
Um, but I really the thepicture that you just painted of
I can't help somebody ifthey're dead.
And if they're in jail, mostlikely they're still alive.
It reminds me a lot of thesituations when people go to the
(26:24):
emergency room, which I've I'msure as an EMT, you saw this.
People have these chroniclifelong conditions.
And for whatever reason, thatday they've chosen today is the
day that I'm gonna go to the ERand get answers.
That's not what the ER is for.
You're gonna show up to the ER,they're going to see, are you
going to die in a couple ofminutes?
(26:45):
No, we're getting you out ofthe ER, you know, that's kind of
similar.
So it it just it reallyhighlights the fact that as
clinicians and as as peoplelooking to healthcare as a
career, you have to know yourrole in medicine.
And we each play a role inmedicine, right?
You've mentioned before, whichI I do want to come back to as
(27:06):
well, that you appreciate thefact that you see people in
crisis in mental health crises,but you are not managing their
care long term.
There are other clinicians whoI'm sure would not know what to
do in crises and serious men,they don't know how to chase
somebody down the interstate,right?
But they appreciate thatlong-term care relationship.
This is the same thing, youknow, we have to manage our
(27:28):
expectations as clinicians andwhat type of medicine we're
going to enter.
And as patients, we have tomanage their expectations of
what they're going to get inthat area of medicine, right?
It's why our ERs are so busyright now.
As, like I said, as an EMT.
I'm like preaching to the choirright now.
Jessi Beyer (27:44):
Yeah, yeah.
And frankly, I've been in theER more as a mental health
professional than I was as anEMT because we get a lot of
folks that end up there as well.
Um, but your point is so valid,and that's something that I
think I I kind of had to learnthe hard way when I got into
this field because I definitelycame into it a little bit
arrogant.
I was like, I'm the mentalhealth professional.
Um, I know what to do.
I'm gonna get these peopleconnected with this resource and
(28:06):
that resource, and they'regonna be fine, and then I'm
never gonna see them again.
Obviously, it doesn't happenthat way.
And so I had to recognize thatmy role is this 10 to 60 minutes
that I have with you.
And if I can be a little brightspot in your chaos darkness of
a life, I have done my job.
(28:27):
And whatever happens once Itake them to the hospital or
once I refer them to detox oronce I find them housing, like
that's out of my control whatthey do in that situation as
well as what that provider doesin that situation.
But I can be really, really,really good at my 10 to 60
minutes.
And that's really what I'vefocused on.
And I would encourage anyonewho's going into healthcare,
(28:47):
exactly like you were saying,know your lane, be really,
really, really good at yourlane, and let everything else
go, or you're gonna driveyourself absolutely crazy.
Ashley Love (28:55):
One of the things I care most about with Shadow Me
Next is helping students preparefor their own pre-health
interviews.
So in every episode, we includea quality question, not to test
you, but to help you practicereflecting, communicating, and
showing who you are.
Jesse Bayer reminds us thatsome of the most important work
in medicine happens in 10 to 60minutes.
(29:18):
Not in long-term plans, not inperfect outcomes, not in tidy
stories, in the moment, inchaos, in space between crisis
and safety.
If you're a pre-health student,ask yourself, can I stay calm
when others can't?
Can I listen without fixing?
Can I sit in discomfort?
(29:40):
Can I be present withoutcontrol?
This is the side of medicinethat shadowing shows us.
The real side.
Keep in mind that there's moreinterview preps, such as mock
interviews and personalstatement review, over on
shadowmext.com.
There you'll find amazingresources to help you as you
prepare to answer your ownquality questions.
(30:01):
I love that.
That is just like, oh, can welike paint that in glowing gold
letters and just plaster iteverywhere?
It would be incredible.
Um, okay, let's shift just alittle bit because I would like
to talk a little bit more aboutmental health and the grand
scheme of things in medicine asa whole.
Um, in your opinion, how hasembedding the mental health
(30:23):
clinicians that you see that youwork with that you are in the
first responder systems?
So this is, you know, coming inwith police officers, mainly
police officers, firefighters aswell, changed outcomes.
How have you seen it improvethe lives of these clients that
you're seeing?
Jessi Beyer (30:40):
It's been revolutionary.
Um, and I want to start thisconversation by saying that I
love my law enforcementpartners.
Like, I think the absoluteworld of them.
I am so lucky to work withthem.
Um, I really just every day Iwalk into work and I'm like, I
love you guys.
And like, shut up, Jesse.
I was like, I know, but I loveyou guys.
So we we have an amazing,amazing relationship.
Um, but this integration ofmental health into law
(31:02):
enforcement is beneficial for abunch of different ways and
reasons.
First and foremost, no one,very few people at least, go
into law enforcement wanting todeal with people in mental
health crisis.
They go in for the burglariesand the fights and the shootings
and all these different things.
Um, generalization, right?
Of course, there's there'sdifferent folks in different
places, but they don't go intoit to talk to the suicidal
(31:23):
person for three hours.
And so for me to come in andsay, hey, you don't want to do
that?
I want to do that.
Perfect, right?
Let's do that trade-off there.
Um, it allows me to take alittle bit more time, have a
little bit more understanding.
Um, and then also bringing thatadditional knowledge.
Cops, especially in the US, aretasked with so many things that
(31:44):
is not actually part of theirjob description.
They are the dumpsters ofhumanity.
And I mean that in the bestpossible way in that when people
don't know what to do withsomething, they have law
enforcement handle it.
And so they have such a widebreadth of responsibility and
things that they do and areinvolved in and are, you know,
responsible for that are notreally law enforcement and they
(32:04):
don't have the adequate trainingfor that.
I mean, yes, a lot ofdepartments go through maybe 40
hours of mental health-relatedtraining.
That's amazing.
I love it.
I have two graduate degrees inthe space.
Like there's just a differentlevel of education there.
Just like I have no idea whatI'm doing when it comes to um
writing a warrant or arrestingsomeone.
Like, I don't know, differentlanes, right?
And so me being able to bringthat additional expertise,
(32:28):
communicate with them of like,hey, this person isn't trying to
be combative right now.
They're actually experiencingchart of dyskinesia and blah,
blah, blah, blah, blah.
And like explain what's goingon to them can change the
outcomes of that.
Um, and then additionally,having the knowledge of those
different resources, like theywill just call me and be like, I
don't know what to do with thisperson.
What do I do with them?
And I was like, okay, great.
Well, you can send them hereand here's a referral and here's
(32:48):
a phone number for this.
Taking that responsibility ofhaving those additional
resources upon myself means thata law enforcement doesn't have
to.
But then also the clients havekind of this one-stop shop of
where they can get referrals todifferent places.
The other thing that I'll sayis that a lot of times the
addition of a mental healthprofessional or the addition of
a crisis negotiator on a SWATcall reduces the use of force.
(33:11):
Um, and I have looked forstudies to back up the numbers
on this and they don't exist,but this is just me speaking
experientially.
There have been a lot of callswhere if I was not there and I
was not able to talk the personinto the ambulance or one of my
negotiators was not able to talkthe person out of the house,
there would have been forceused, there would have been gas
bombs thrown in the house, therewould have been, you know, all
(33:32):
these different things thatmaybe would have escalated that
situation.
But because we come with adifferent perspective and a
different personality and adifferent base of knowledge,
those outcomes are potentiallydifferent.
Not all the time, doesn'talways work.
Um, but in terms ofnegotiations, at least the the
statistic out there is like ifwe can get on the phone with
them, about 80% of the timewe're able to negotiate them out
(33:53):
instead of having to use force.
So there's that element to itas well.
Um, very rambling answer, butthose are some of the benefits
of um implementing mentalhealth.
Ashley Love (34:01):
Not rambling at all.
No, that was that wasfantastic.
Great examples as well.
And I would imagine, you know,we we were TV is not real life,
and we watch all the SWAT showsand we see them busting into
houses and they're like soexcited about it and they love
it so much.
And I would imagine there aresome people that do love that.
However, I would also imaginethat most of them are thrilled
to have you so that they don'thave to do that, so that they
(34:24):
don't have to traumatize thisperson where they're not out to
traumatize people, right?
Jessi Beyer (34:29):
No, absolutely not.
Just a note on TV before Iactually respond to that.
Um, I love the show CriminalMinds.
I watched Criminal Minds likereligiously when I was a kid.
Um, it makes me so angrybecause everything that they do
negotiation-wise in that show islike wildly inaccurate.
And I'm like, no, no, we wouldnever do that.
That doesn't work that way.
So, yes, not real life.
Um, in terms of your actualpoint here, it's very, very
(34:53):
true.
There are 100% people that arelike, hell yeah, I want to go
boot down the door.
We have moments of hell yeah,I'd like to go boot down the
door as a mental healthprofessional.
Like, we all have those momentsof, yeah, we want to get in
there, we want to go after it.
Um, but there's also timeswhere they don't.
Um, and for example, we had aclient one time, 400-pound
trained MMA fighter, flurriedlypsychotic.
(35:13):
Um, and there was a warrant outfor his arrest.
And so I call him, and thefirst thing he says is, like,
what do you want?
If any cops come to my door,I'm gonna fight him.
And he had a history offighting law enforcement.
And I ended up talking him outof the house.
It was peaceful, he gotarrested, it was all good.
But I was talking to mysergeant afterwards, who's on
the SWAT team, and he was like,I am so glad you were here
because I did not want to get inthat fight.
(35:34):
And I knew that if we got intothat fight, he was going to the
hospital and we were probablygoing to the hospital too.
And so there very much is thatperspective of, yes, okay, harm
reduction is amazing, but I amliterally preventing sometimes
my deputies and my clients fromgetting punched in the face.
Um, and that feels really good,like to be able to have that
influence and just keep thephysical safety of people safe
(35:56):
as well.
Ashley Love (35:56):
Which is incredible too, because this is a very
much of a side note, but yourhobbies are incredibly physical
and very, very tough.
So, you know, I I couldprobably bet on you against a
400-pound MMA fighter.
I feel like you could probablytake them, even if you wanted
to.
But again, that that is anaside.
We do not have to go there.
But definitely check outJessie's Instagram and some of
the really, really cool thingsthat she's doing there.
Let's talk directly to ourclinicians now and our future
(36:18):
clinicians.
What do you wish that everyfuture clinician or current
clinician understood aboutsuicide risk that we are
missing?
Jessi Beyer (36:29):
Yes.
This is where I get on mysoapbox.
In specifically primary care,um, about 75% of people that die
by suicide have seen theirprimary care physician in the
year before they died.
And in most primary caresettings, there is no screening.
There's no discussion.
At most on an intake checklist,there is a have you experienced
(36:50):
thoughts of harming yourself orothers?
Yes or no.
And then that's kind of the endof the discussion.
Primary care physicians,clinicians in general, and I'm
I'm almost intentionallyexcluding emergency clinicians
here because they get this allthe time, like that's a pretty
common part of their life.
But like everyone else, you arein a prime situation to screen
for patients that areexperiencing suicidal ideation,
(37:13):
to do risk assessments, to doreferrals, and to literally save
these people's lives just byasking a few questions.
And that is what I getincredibly passionate about when
talking to healthcare teamsbecause they're like, oh, you
know, I'm I'm a dentist, right?
Or I'm primary care or I'm anOBGYN, like whatever.
I'm not dealing with people incrisis.
And what I tell them is thatyes, you are.
(37:34):
You just don't know that yourpeople are in crisis.
Or they're presenting with somesort of somatic symptom that
is, you know, a chronic stomachache or chronic headache or um
their acne has flared up out ofthe blue or whatever that is.
Putting those pieces togetherand understanding not to get
like too woo with it, but likethe mind-body connection and the
fact that what's going onupstairs is going to be
(37:54):
reflected in the rest of thebody, recognizing that,
understanding that, and takingthe five minutes to sit down
with your patient and say, Hey,what are you doing?
Like just tell me about yourlife.
I I hear that you're here for astomachache, but what else is
going on for you?
No one does that.
No one does that.
And so taking that time, theymight say, Oh, yeah, you know,
it's okay.
You know, you know, work'sbeen, you know, up and down
(38:16):
lately, but all in all thingsare good.
Okay, you know, up and down.
What do you mean by that?
What's been going on there?
Oh, well, you know, um,actually, I I just got fired
recently.
Okay, now we're gettingsomewhere, right?
Now we're digging in and we'rehaving this conversation and
you're learning things aboutyour patients that you wouldn't
if you just had that intakecheckbox, do you want to die or
not, type of thing.
So you are you as a clinician,right?
You are at this criticaljuncture where you can intervene
(38:39):
in your patients' lives in waysthat you probably don't think
you can, and that statisticallyyou absolutely need to.
Ashley Love (38:46):
You're right.
And it's it does take a minute.
And I think that as clinicians,we hear that and we think,
well, I only have 20 minutestimes 30 appointments throughout
the day.
But every each of those 30appointments, you're not going
to be having this conversation,right?
I mean, this is something thatmaybe you pick up um a handful
of times and you address it, andmost people will just blow you
(39:06):
off, or there's actually nothingwrong.
But that one person that thereis, and that one person that you
really get to tap into.
Um, there's this happened to mein clinic, and I am in
dermatology.
So very much in that wholerealm of things, we had a
patient come in.
She was very hesitant todisrobe, to take her clothes
off, which is kind of part ofder if we, if you're there for
us to look at your skin, we haveto be able to see your skin.
(39:28):
Um, extremely hesitant, thepoint where my medical assistant
came, got me, and said, Hey,listen, I don't think we're
gonna be able to do this, etcetera.
I walked in just so that shecould meet me, even if we
weren't doing a skin check thatday.
Recognized something, I don'tknow, a little that spidey
sense, right?
Um, and we dove into it alittle bit.
She's a sexual assaultsurvivor, literally within the
(39:52):
last number of weeks, but shedidn't want to cancel the
appointment because she's tryingto normalize her life, which I
was so proud of her for doing,et cetera.
Um We didn't take her clothesoff at that appointment.
We sat there and I had a20-minute appointment slot.
So we talked for 20 minutes,right?
And then I said, Hey, whenyou're ready, I would love for
you to come back in.
How can we make thiscomfortable for you?
How can we make thisappropriate for you so that I
(40:13):
can check the areas of your skinthat you want me to check?
Um, and we did, and you knowwhat?
Every single time she comes in,she brings a gift, which is so
sweet.
She does not have to do that.
But I'm just so gratefulbecause um, you know, first of
all, she has gorgeous skin, soshe doesn't need to be there to
see me, but I'd like to thinkthat that positive experience is
hopefully going to fuel otherpositive experiences for her in
(40:34):
healthcare to where she can goback to see her GYN and she can
get those routine exams and shecan see her male PCP.
Um, so it, like you said, youknow, sometimes it just takes
that one brief, brief moment.
And uh it's it's one of myabsolute most favorite stories
in healthcare.
And it started off withsomething so miserably painfully
sad and a terrible conversationthat I had to have with the
patient.
But um, what a greatrelationship it is now, you
(40:57):
know, it's really, really cool.
Jessi Beyer (40:58):
That's amazing.
And I know that you are not theone being interviewed, Ashley,
but like that story just oh mygosh.
I mean, it warms my heart somuch.
It's obviously terrible andtraumatic and it makes me sad at
the same time.
But knowing that there areproviders like you out there
that took that time, that sawthat warning sign and did
something with it, like justgives me so much hope.
Um, and I'm not overstatingthis, like I'm saying this as
(41:20):
someone who sees crisis everysingle day, sees sexual assault
survivors every single day.
Um, you may have saved herlife.
At the very least, you changedthe trajectory of her life
dramatically.
Um and her life could havetaken a very, very different
turn if she didn't have those 20minutes with you.
And so for everyone who'slistening, who's considering
going into healthcare, who'salready in healthcare, obviously
(41:41):
you want to help people, youwant to make a difference in
people's lives.
But maybe you're in a fieldwhere you're like, I don't save
lives, you know, like I helppeople, but I'm not saving lives
in this profession.
You are, and you can.
You just have to take those fewminutes and have that
conversation and invest thattime in someone who, yeah, came
for her skin, but she needed anear and a shoulder and someone
(42:03):
to be there with her.
And you gave her that.
And that's amazing.
And it makes me very happy.
Ashley Love (42:07):
I like yeah, I never even thought of it that
way, Jesse.
But you're you're right.
I mean, you're right.
Obviously, this is this is whatyou do.
You're absolutely right.
And um, you know, to me it wasjust 20 minutes, but who knows
what it was, uh, what it was forher.
Oh my gosh.
Before we really wrap up, ifthis conversation is just really
influencing you and you youwant to know more, I would
highly recommend you pick upJesse's book.
It's called How to Heal (42:28):
A Practical Guide to Nine Natural
Therapies You Can Use to ReleaseYour Trauma.
And this is amazing because itsounds like it was written for
trauma survivors, for people whohave experienced trauma.
But I will tell you, as aclinician, this book is
invaluable because I'm going tobe, I have, as I've mentioned,
talked to these people.
And having some of these toolsthat you've talked about, things
(42:50):
like eye movementdesensitization, um, dance
movement therapy, canineassisted therapy, which of
course, knowing your backgroundand as a maybe veterinary
medicine practitioner at onepoint, this makes a lot of
sense.
Equine, of course, as well.
Um, uh, ecotherapy andnature-based therapies.
These things are amazing.
And just would give people somuch hope to, you know, like I
(43:12):
said, to come to yourdermatologist and have your
dermatologist talking aboutdifferent therapies that they've
learned from you.
Um and uh just tell us a littlebit about this book, who it was
written for, and uh, and whatyou hope to do with it.
Jessi Beyer (43:26):
Yeah, so this book was a passion project for me,
and it really was born out of myown experience, like I
mentioned, thinking that Ieither could go to talk therapy
or I had nothing, and I had tokind of figure it out by myself.
Um, and I realized that thatwasn't the case.
There are other modalities outthere.
And so this is really writtenfor the person who has tried the
traditional trauma therapiesand they haven't worked for
(43:47):
them, and I will go into that injust a second.
Or for the people who don'twant to try, they're
uncomfortable with that for somereason.
There's some part of theirstory that doesn't align with
that, and they're looking forsomething else.
Um, so these are allwonderfully rich methods of
healing from trauma, body-based,movement-based, nature,
animals, all these differentthings, very holistic methods of
healing from trauma that arealso empirically supported.
(44:09):
Because I'm as much of a datanerd as I am like this woo-boo
fluffy, hug a dog and feelbetter type of person.
Um, so they're really wonderfulmodalities there.
In terms of kind of traditionaltrauma treatment, when I
reference that, uh, the AmericanPsychological Association
recommends a few talk-basedtherapies and then some
medications for traumatreatment.
So we're looking at cognitivebehavioral therapy, we're
(44:30):
looking at exposure therapy.
Um, those are kind of the twobiggest ones, and then your
combination of SSRIs and SNRIsfor medication-based trauma
treatment.
Um, and the APA, the AmericanPsychological Association, likes
to kind of tout these as thegold standard and everything
else is subpar.
And if you really dive into theliterature on these different
modalities, depending on thestudy, it's about 50% of people
(44:54):
that achieve benefit from thosetherapies.
And then if you get evenfurther into that, you have to
determine whether benefit meansa clinically or I'm sorry, a
statistically significantreduction in clinical symptoms
or a reduction in symptoms to alevel below the diagnostic
criteria.
Because some of these studies,to simplify the diagnostics on
(45:14):
it, um let's say that you comein with 10 out of 10 on the
trauma scale, on the PTSD scale.
Um, and then the the baselinefor diagnosis is a five.
So you have to at least get afive to be diagnosed with PTSD,
but this person comes in with a10.
Well, they got down to an eightbecause of this treatment.
Yay, it's a huge success.
They still have PTSD.
Like they're still incrediblysymptomatic from this.
And so as you're reading thesestudies, you really have to get
(45:37):
into like what is considered asuccess?
Is it clinical remission or isit a significant reduction in
symptomology?
Both are good, but it it landsdifferently depending on what
you're looking at there.
So my point of that is there'sa lot of folks that are helped
by these therapies.
And I love those therapies forthose people.
There's also a very large chunkof people that are not.
And what happens in thisAmerican Psychological
(45:59):
Association-based world oftreatment that we live in is one
of two things.
The patient gets blamed.
So there's a lot of studies outthere that talk about, well,
patient noncompliance andpatient refusal to engage and
all these different things.
And my response to that is ifyour therapy is so traumatic
that no one wants to do it, itdoesn't work.
Like it's not good enough.
We need to amend that.
Um, so that that is one thingthat'll happen is the patient
(46:22):
will get blamed, or they will betold there's nothing else.
There's nothing else out therefor you.
You either have to do this oryou're on your own.
And so my book was reallycreated for that person who's
been in that experience to say,hey, it's not your only option.
There are other things outthere.
And it's very much written,human to human.
It's not clinical language.
It's me just blabbing like I amright now about all these
(46:43):
different modalities.
Um, so it's very approachable.
In a lot of them, I actuallywent to that therapy.
And so I talk about here is myexperience, here's what we did,
here's what it felt like, herewere the revelations that I went
through.
Um, and getting kind ofpersonal with some of that.
So people can maybe experiencea session before they actually
have to go themselves.
Um, and so yeah, I mean, that'sthat's my goal with it is
spread awareness, spread hope,and spread options for people
(47:06):
that are looking to heal, butdon't feel like the
traditionally presented optionsare gonna work for them.
Ashley Love (47:11):
Oh my God.
Awareness, hope, and options.
Could we want nothing more?
It's just a fantastic gift thatyou have given.
The book, again, is called Howto Heal: A Practical Guide to
Nine Natural Therapies You CanUse to Release Your Trauma.
It's available on Amazon.
Um, and if you guys have fallenin love with Jessie as much as
I have, please check her out onInstagram.
It's Jessie Bayer.
(47:32):
That's J-E-S-S-I-B-E-Y-E-R.
It's Jesse Bayer.
Um check her out on LinkedIn,same name.
And then, of course, on herwebsite, Jessie Bayer
International.com.
Jesse, thank you, thank you,thank you for the work that you
do.
I am so glad to know that thereare people like you out there
(47:53):
um meeting us in our deepest anddarkest moments.
And like you said, you are justthis small beacon of light.
Um, and thanks for joining uson Shadow Me Next and sharing
your story today.
Jessi Beyer (48:03):
Absolutely.
Thank you for having me.
And anyone who's listening, ifyou're curious about this field,
it is new-ish.
Like it's we're kind of on theforefront of it.
So if you have questions, ifyou're like, I'm curious about
it, I want to try it, I want tolearn more about it, like shoot
me a DM, shoot me an email.
I'm happy to just talk aboutwhat I do and help you figure
out if it's something thatyou're interested in as well.
Ashley Love (48:22):
Incredible.
Thank you so much, Jesse.
Thank you so very much forlistening to this episode of
Shadow Me Next.
If you liked this episode, orif you think it could be useful
for a friend, please subscribeand invite them to join us next
Monday.
As always, if you have anyquestions, let me know on
Facebook or Instagram.
Access you want, stories youneed, you're always invited to
(48:43):
Shadow Me Next.
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