Admitting you need help during a mental health crisis takes extraordinary bravery. But in a fragmented healthcare system, that courage is rarely rewarded with quick access to the care you need. I learned this the only way I learn anything - through first-hand experience, incredibly painfully. When I finally gathered the strength to say I was struggling with suicidal ideation, my therapist let me know that my needs were too severe to continue care with her. I was faced with an impossible choice: wait six weeks for an open spot in an Intensive Outpatient Program (IOP) or go to the emergency room. She told me she knew going to the ER felt extreme, but that it would be the fastest way for me to be connected to care.

Neither option felt like real help in the moment when help mattered most. I live in New York City, where we have 24/7 access to almost everything. How could people be left waiting when waiting is the most dangerous thing they can do? I was scared of what going to the hospital would entail, and I tried to ride it out on my own, but ultimately realized that waiting wasn’t a safe option. My husband drove me to the ER. Looking back, I made the right choice, but it doesn’t feel fair that I had to make it. Once I went through my own experience, I started speaking with others who had been through similar journeys. In that process, I learned that I’m, unfortunately, not alone. Over 7 million people in the past year sought out behavioral health care in the ER. This trend is only accelerating, with 20%of high school students reporting seriously considering suicide in the past year.

Mental Health Crises Shouldn’t Be the Emergency Room’s Responsibility.

For most hospitals, resources to triage and treat those in crisis are lacking. ER teams save lives every day, but most are not structured to support patients with acute behavioral health needs. In the words of a friend in Emergency Medicine, “Are you having a stroke? If so, I know how I can help you. If you’re having a mental health crisis, what I can do is less clear.”

Long wait times, lots of noise, minimal privacy, and a focus on quick stabilization is simply at odds with the needs of people in behavioral health crises. High facility costs can also be a barrier, especially if a patient is under insured or uninsured.

For those who do go to the ER, access to ongoing care post discharge is far from guaranteed. Nationally, only 40% of patients who visit the ER for behavioral health reasons are seen by a clinician within 7 days of discharge. With this lack of consistent connection to ongoing care, 1 in 4 behavioral health patients return to the ER within 90 days. Today’s system is simply not working for patients in crisis.

Finding a Better Way Forward Requires Looking Around at What Works (and Doesn’t Work) Today.

As you’re reading this, you’ve probably already started to ask yourself - “wait, haven’t we already addressed getting urgent access to care outside of the ER?”. For physical health, we have. If you think you may have an infection, you need care quickly, but you don’t need to show up at the Emergency Room to receive it. Urgent care has transformed access to time sensitive physical health needs, but there has not been an effective equivalent in behavioral health. Nearly 17% of ER visits for mood-related disorders could have been avoided if timely crisis-level outpatient crisis care existed.

Beyond urgent access to care, the next challenge is the quality of care you receive once it becomes accessible. The standard of care for patients with more acute behavioral health needs that can be supported outside of the hospital is an Intensive Outpatient Program (IOP). IOPs are typically structured as at least 3 hours of group therapy sessions 3-5 days per week. Patients like me who are escalating from standard outpatient therapy are going from 45 min of 1:1 therapy to 9+ hours of group per week. For many patients, that time commitment isn’t possible to maintain, besides other critical work and family responsibilities. That limited universe of options leads patients to skip ongoing care, even when it becomes available.

The Missing Piece in the Behavioral Health Continuum.

Rather than sitting on the sidelines, I started having conversations with individuals across the system (payers, providers, policymakers, other patients, etc.) to figure out if there was an opportunity to close the gap for people in behavioral health crises. That discovery process informed what we built and continue building at Willow Health. A virtual crisis clinic like Willow Behavioral Health fills both of these critical gaps by providing:

● Rapid access to care within 24 - 48 hours - not weeks.

● Easy referrals from partners across the healthcare ecosystem, including hospitals, therapists, primary care providers, and 988 lines.

● A comprehensive support team which includes psychiatric providers, therapists, certified peer specialists, and care managers.

● Personalized treatment plans tailored to each patient’s clinical needs and lifestyle.

● 24/7 access to on-call human support.

● Flexibility, privacy, and continuity so patients can stay in school, at work, and at home.

Our program is not a replacement for ERs or inpatient psychiatry units for all patients - there are individuals who greatly benefit from that level of in-person oversight. But for the many patients who can be safely cared for in the community, Willow’s program serves as a bridge to start their journey toward recovery

What is Willow, and How Does It Fit into the Ecosystem.

At Willow Health, we work as a referral partner to therapists, primary care providers, hospitals, and tech-enabled solutions like 988 to provide patients urgent access to personalized, evidence-based, and compassionate care.

We combine clinical expertise, technology, real-human support, and coordinated transitions to create an impactful and sustainable approach to crisis care and recovery.

We see people who otherwise might fall through the cracks, such as those experiencing suicidal ideation or a psychiatric emergency for the first time, young adults whose symptoms escalate faster than their therapy provider can accommodate, or people for whom a traditional in-person IOP is not realistic. The common thread is urgency and the need for a discharge plan or quality referral to clinical support within days, not weeks.

Final Thoughts.

As an industry, we have the opportunity to build a system that meets people with dignity, urgency, and expertise. Virtual crisis care is one way we get there — and it’s time for it to be a standard, not an exception. Bringing together innovators and experts at conferences such as Behavioral Health Tech is a reminder of how many out there are as dedicated to the same cause as the Willow Health team. It gives me tremendous hope for the future.

Suicidal ideation should not be stigmatized. Asking for help is an act of clarity, not weakness. Our job as a society is to help those in need recover and continue their life with purpose.

If you are experiencing suicidal ideation, know someone who is, work with patients who may be in need of an option, or want to know what to do in a mental health crisis, you’re not alone, and help is available. Visit us at willowbehavioralhealth.com to learn more or reach out.