Utah struggling to cover the costs of growing demand for urgent mental health services

SALT LAKE CITY — The need for urgent mental and behavioral health services is growing rapidly throughout Utah, putting unexpected demand on the organizations and facilities that provide around-the-clock care for Utahns in need.

But available crisis systems are making a difference, officials note.

"We’re sending out (emergency management systems) to interrupt suicide almost on a daily basis," said University of Utah Neuropsychiatric Institute Executive Director Ross VanVranken. "It’s really making a difference in a lot of people’s lives."

He said institute staff last month received 233 texts and tips from students and parents regarding mental health distress within the state, and while 139 of those were referred back to the schools for further investigation, emergency teams were able to save the lives of 25 people.

Since the smartphone app SafeUT was released, VanVranken said youth suicide rates have decreased 12.5 percent.

Funding for the growing need for mental health services in Utah, and particularly crisis care, however, can't keep up, according to an audit released Wednesday by the state's Office of the Legislative Auditor General.

"You can’t have a crisis system or call system where nobody answers the phone," VanVranken said, adding that staff is trained to answer the needs of whatever problem arises, typically helping to de-escalate serious mental health situations.

Workloads for real-time responders at the SafeUT crisis text and tip line/smartphone application grew more than 1,000 percent from 2016 to 2018, according to the audit. It also found that peer support offered to Salt Lake County callers at the Warm Line increased 54 percent during the same time.

Auditors found that the demand for services offered to callers of the national suicide increased 29 percent during those three years, while the University of Utah Neuropsychiatric Institute's Mobile Crisis Outreach Team served 26 percent more callers than in previous years.

Call volume fluctuates from month to month based on various triggers, such as seasonal changes and reports of celebrity suicides, according to the audit report. Staff has also reported that the severity of the calls is increasing, as more callers lack adequate support systems.

These calls, the report states, "occupy a mental health professional for up to an hour." Mobile outreach requires up to three hours for a team to make contact with individuals who need immediate assistance.

In June 2018, the crisis center received 5,521 calls for help, resulting in 325 situations involving mobile outreach teams, the report states.

Increased use of the available services is a positive thing, said Rep. Brian King, D-Salt Lake City, adding that it shows the state is making progress and successfully generating awareness.

"It's a good thing that people are using it," said the committee chairman, Senate President Stuart Adams, R-Layton. "The whole intent of the SafeUT app is to save lives."

Use of the SafeUT app, however, declines during the summer, when school is out, audit supervisor Wayne Kidd said.

The audit recommends that the institute continue using innovative techniques to help manage the growth in crisis services, as well as gather caller feedback to ensure quality assurance. It also asks that the legislature be kept up on deficit concerns, as it appropriates up to $10 million to help with crisis management services.

Six funding sources covered 94 percent of the more than $20 million in operational costs for the various crisis teams across the state (most of which are offered in Salt Lake County) over the three fiscal years from 2016 to 2018, with the remaining $1.16 million covered by University Neuropsychiatric Institute and University Hospitals and Clinics.

The psychiatric treatment facility projects a shortfall of $3.6 million in 2020 due to the ongoing growth in the need for urgent mental health services, which VanVranken calls "a critical benefit to the health of Utah citizens."

The increasing demand for services has been handled "with a sense of community as there was not a similar growth in funding," VanVranken said.

He said the teams at the University Neuropsychiatric Institute and at U. Hospitals and Clinics, which oversees the mental health facility, "will continue to look for ways to streamline service delivery, but the volume growth will likely go beyond our ability to keep up."

All of Utah's public high schools and middle schools have opted to use the SafeUT app, as well as all 16 of Utah's higher education institutions, which has also contributed to the increase in usage, according to the audit.

The audit also invalidated concerns that University Neuropsychiatric Institute favors certain rehabilitation treatment centers when discharging patients.

If someone you know is struggling with thoughts of suicide, resources are available. In Utah, the SafeUT app provides a direct connection to a crisis line.

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