Resources for Mental Health Care Beyond 988
CW: mental illness, depression, s-, s- ideation, hospitalization
Context: Providing support for those in a mental health crisis beyond 988 and NYCWell
The United States is in the midst of a mental health crisis. I found myself in the middle of it. I have been living with mental illness since I was a teenager, and just went through a period of crisis myself. I’ve been writing a longer piece centered on mental health and the mental health care system, but I feel a sense of urgency to share a few resources that helped me for those who are in crisis now. Hopefully there’s something here you haven’t heard of yet!
Crisis respite centers-
A possible alternative to hospitalization for those who are capable of maintaining their own medication management and not in imminent danger. Good for those who may have fear of or have trauma from involuntary and/or inadequate medical care. Also good for those who are worried about the cost of care or missing work due to seeking care. Crisis respite centers offer a temporary place to stay for up to 28 days with 24/7 peer counselor support. It is a home-like environment where you may come and go as you please, continue working if you need to, have a pen and wear shoelaces, etc. Alongside providing sincere emotional support, staff are skilled in connecting guests with community resources like healthcare, housing, groups, and other local organizations that assist with even more, like employment. If this is an option for you, a crisis respite center can offer more emotional and long-term planning support than an emergency department is capable of. My stay was 100% covered by insurance.
NYC has four crisis respite centers located throughout the city. Admission requires some documentation- for me it was a referral from my therapist and a couple forms for me to fill out- and took around a week for me to get in.
You also have the option to pursue more rigorous outpatient care elsewhere, allowing you to receive intensive care and rest at home.
Unfortunately the s- prevention hotline, now 988, is a service with a limited scope of care. Callers may have the expectation that they can freely discuss their feelings, including s- ideation, and receive support or just some relief after getting that off of their chest. Instead, responders are trained to evaluate risk and make decisions based on their perception of your risk. Callers who do not seem to be in imminent danger may be let go or hung up on without a plan for ongoing care. Callers who do seem to be at risk may result in the responder alerting emergency services- sometimes involving police presence- without the knowledge or consent of the caller. Involuntary hospitalization, police violence, and even arrests are sometimes the result of calls to this number.
As a possible alternative/another option, there are warm lines! (As opposed to hotlines.) These are what you want to call if you actually want to talk to somebody about your feelings.
Just google warmlines and a few sources like MHA and NAMI have lists of multiple available. They are listed by state, but I’ve never had somebody ask for my address. Call every state if you have to.
A counselor at the Crisis Respite Center told me about and got me in touch with the Brooklyn Clubhouse.
Clubhouses “offer people with mental illness opportunities for friendship, employment, housing, education, and access to medical and psychiatric services in a single caring and safe environment.” They all operate with the same model, which I find uniquely empowering to those they serve. Each clubhouse is ran by the staff and the members as a team. All meetings and decision making is meant to include the members. Everything is voluntary. Along with all of the previously mentioned services, they also provide breakfast and lunch Monday-Friday. There are recreational activities.
There are several clubhouses throughout NYC and for those of you located outside of NYC, this is an international organization with more than 300 locations.
I underestimated the power of hearing somebody else say what I’m thinking and feeling a little less isolated. The National Alliance on Mental Illness (NAMI) hosts several virtual peer-led groups for different communities. If you’re LGBTQ, The LGBT Center has many virtual and in-person groups as well. They also offer assistance for those seeking to get insurance/healthcare.
On finding a therapist or psychiatrist-
It is difficult. I’m so sorry for that. We all deserve better.
When you find a list of professionals that take your insurance and you begin calling them, some may not call you back at all. Some might not take your insurance any more. Many may not be taking new patients. Then, there’s the matter of cycling through the ones you finally get a hold of to find one you like and that can help you. Don’t be afraid to break up with your therapist. Don’t be afraid to ask for that sliding scale from out-of-network therapists. I want to encourage you to persist. I want you to ask for help on these difficult, bureaucratic, labor-filled steps from your loved ones. You deserve adequate care.
It’s 2022. We’re not stigmatizing medication for mental illness anymore. We know about 1 in 4 adults suffers from a diagnosable mental disorder in a given year.
The majority of people who try medication to ease their depression will not find the first medication and dosage that they try adequate. Commitment to experimentation is crucial.
Nothing is ever the last option, especially not zoloft.
A lot of my depression this go-around was about the state of current events and my feelings of powerlessness and hopelessness in their wake. I’ve found that my ability to make a difference in my local community is muuuuch greater and much more tangible than my influence on national/global politics.
Posting this offering with the thought:
There are more resources available than we think and more people trying to solve the problem than we think.
Hope is a discipline.
Recommended reading: All About Love by bell hooks; Emergent Strategy by adrienne maree brown; Trauma Stewardship by Laura van Dernoot Lipsky; The Noonday Demon by Andrew Solomon, Living for Change by Grace Lee Boggs.
Currently reading: Lost Connections by Johann Hari and What We Owe to Each Other by T.M. Scanlon.
Also highly recommend screaming along to Fiona Apple.
We’re in a moment of history together. Things are changing quickly. That’s also a really exciting opportunity for change. I’m here for you if you need me. <3