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Daily Briefing

Mental health care in the US is 'broken and bewildering.' Can navigators help patients find the care they need?


The mental healthcare system in America is "broken and bewildering," and finding appropriate care can be a struggle for both patients and their families. However, mental health navigators can help alleviate this problem by connecting patients to a wide range of available care options and resources, Benedict Carey writes for the New York Times.

The growing need for mental health navigators

"When a family is upended by a suicidal son, a bulimic daughter, addiction or psychosis, it's a rare person who knows whom to call for help or even how to ask," Carey writes. "Try searching online, and you'll no doubt find an assortment of out-of-date directories, random advice and dicey-looking services that may or may not provide what's advertised."

Although hundreds of thousands of families struggle with mental health crises every year, many are on their own when it comes to finding help. The pandemic also exacerbated problems by straining mental health services and revealing the profound difficulties patients have with accessing care.

One way to address this problem is through the use of mental health navigators, who provide what Carey calls "humane, knowledgeable guidance." At Mental Health GPS, a nonprofit organization in North Carolina that Carey works with, volunteers provide callers with confidential and independent "navigation services" to help them find appropriate care for their problems.

During a call, volunteers collect basic data such as age, location, and insurance coverage if applicable, and use this information to search up-to-date databases for different care options, including therapists, clinics, detox programs, peer support groups, and more. If none of these options work out, people are free to call back and get more help.

According to Carey, the service received roughly 800 legitimate calls during its first year of operations. Roughly a third were from individuals under the age of 25, and many were "distraught over school, a breakup, work or a family conflict," he writes. Of the callers, between 10% and 15% were able to calm down after a conversation, "knowing they can call back and that we can find them help quickly."

What's needed to make mental health navigation successful

Although mental health navigators have been around for decades, many of them have expensive fees ranging from "$100 to $350 an hour or up to at least $5,000 per quarter," Carey writes. To help smaller nonprofits, which provide their services at no cost, scale up effectively, three components are needed:

1. A sophisticated tech back end

According to Carey, search engine optimization is needed to increase an organization's "visibility on the web and data-analysis algorithms."

At GPS, all of the basic information on their calls is stored and anonymized to allow the organization to analyze trends and update data about services available in their databases.

2. Comprehensive databases

A comprehensive database that covers a full range of services and support options is important to helping people find the care they need. In particular, Carey notes that the databases at GPS include many low-cost, nonclinical support options, such as emotional support lines and data on local AA meetings.

3. The ability to assist people in critical moments

"[A]ny decent navigation service should be about talking to people at a critical moment, exactly when they have summoned the courage to ask for help," Carey writes. "It means not just a sympathetic ear but also informed context."

Ultimately, mental health care is "human work," and "[n]o bot can do all this adequately and sensitively, and no A.I. program can ever simulate the experience of people who have been through the fire shower of a mental health or substance use problem," Carey writes.

At GPS most call takers are "peers," or people who have gone through their own difficulties before and understand the frustration with finding adequate care. This gives them unique insight into the people calling for help since they are, in effect, "taking calls from versions of their former selves."

Overall, the American mental health care system is "broken and bewildering," and necessary reforms will likely take time, so "for now, let's at least give people someone knowledgeable to talk to," Carey writes. (Carey, New York Times, 2/12)


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