Dr. Rozel

Dr. Jack Rozel, Medical Director, resolve Crisis Services discusses the mission and work of this 24/7 crisis services hotline, as well as other options available for counseling and mental health care for those in need.

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Read The Full Podcast Transcript

– [Host] This podcast is for informational and educational purposes only. It is not medical care or advice. Clinicians should rely on their own medical judgments when advising their patients. Patients in need of medical care should consult their personal care provider.

– Potentially life-saving crisis services just a phone call away. Welcome to the UPMC HealthBeat Podcast. I’m Tonia Caruso, and joining us right now is Dr. Jack Rozel. He’s the medical director of resolve Crisis Services. Doctor, thanks so much for joining us.

– Thanks for having me, Tonia.

– So let’s begin by telling people exactly what resolve Crisis Services is and does.

– So, resolve was created a little over a decade ago as a joint partnership between Allegheny County and UPMC. And at the time, the idea was to create a one-size-fits-all, one-point-of-access crisis program for all of Allegheny County. And we’ve brought together a variety of services, including phone, mobile, walk-in, and residential crisis services, all available 24/7, 365, free of charge to anyone in Allegheny County.

– And so let’s tell folks the number of resolve Crisis Services.

– The number is 888-796-8226 or 888-7-YOU-CAN.

– And so what happens when someone calls this number? Who should call this number?

– So who should call is someone who is starting to feel overwhelmed, starting to feel like they’re not sure what to do next, that their situation in life is getting to be too much, whether it’s sadness, anxiety, housing, employment, anything at all that feels like it’s getting to be just too much. And what we always say is, you know, call before a crisis becomes a crisis. And of course, if you’re doing well, but there’s someone in your life that you care about that you’re concerned about, that they start to, you know, reach that point where you’re concerned, absolutely do not hesitate to reach out.

– And so have you seen new trends, or what has that been like? Have you had more calls since the onset of COVID-19?

– So there’s been a lot of discussion and sort of play around what’s happened to the numbers to crisis centers over the past six months, especially as COVID had its initial peak or bump in the process. Our volumes have been steadily growing. Early in this crisis, we saw a little bit of what we call sort of the drawback: People were a little bit more anxious or concerned about reaching out for services and are sort of gathering or clustering at home. But now we’ve certainly seen their return to our baseline volumes, if not an increase. There were some maybe overplayed stories in some of the media about huge surges in calls. And a lot it was sort of taking some small numbers out of context for one very specific crisis line, but like most crisis lines across the country, we’re seeing a gradual increase rather than, you know, 800 or 1,000 percent increase.

– Right, and you touched on this. Can you talk about that you have a 150-member team? Can you talk about some of the folks who make up that team?

– So I, you know, I have the privilege of working with 150 of, you know, the smartest, kindest, most compassionate and dedicated people I’ve ever had a chance to join. And we have nurses, and we have clinicians, and we have peer specialists, and we have service coordinators, and of course, we have some psychiatrists and nurse practitioners as well — all of which are available as people come in to say, “Hey, you know, how are you doing? What’s going on? How can we help you get through whatever it is that’s in front of you?”

– And what is the process like when someone calls or when someone goes into the walk-in clinic? And can we tell folks where the walk-in clinic is?

– Sure. Our walk-in site is it 333 North Braddock Avenue in the Point Breeze/Homewood area of the city. And, again, it’s open 24/7, 365, no appointments needed. And whether someone comes up to the door and says, “Hey, I need help,” or, “I’m with my loved one who needs help,” or if they’re calling us to have a team to go out, we do a couple basic things every time. Obviously, we learn who that person is, a little bit about what the crisis is about. And one of the really nice things I like about resolve is the crisis is defined by the individual. It doesn’t have to be, “I’m depressed, I’m anxious.” It doesn’t have to be, “I’m off my medications.” It can just be, you know, “My marriage is falling apart. I’m feeling overwhelmed.” There’s nothing about living with a major psychiatric illness like bipolar or PTSD, that keeps you employed that, you know, keeps your relationship stable, and we want to focus on whatever that person is telling us, “This is my crisis today.” We always screen about important risk issues like suicide or violence. We send out many mobile teams every day across the county to help people out. We do a little bit of questions about you know, “Is the home safe? Are there, you know, dogs or things like that? But basically, what we’re saying is, you know, “Who are you? Who’s the person we need to be concerned about, and how can we help?” Our mobile teams are usually two-person teams, they’re in a plain old vehicle, they’re in casual clothing, and they’ll have a UPMC ID tag. But other than that, you know, they’re not bringing special uniforms. They don’t have any logos on the vehicle. So no one is going to know, “Hey, these people are coming out to my house.” We always call on our way to say, “Hi, this is the mobile team,” to introduce themselves, and to say, “We’re the ones who are coming into the house,” just to take a little bit of that edge, that anxiety, off of the family as they’re waiting for the team to arrive.

– And there has often been a stigma attached to mental health. What do you want to say to people about the importance of seeking care, and really steps the community is taking to try to get rid of that stigma?

– So, you know, I think the simple thing is to look at the numbers. There’s a new study just this year that came out of New Zealand, and they said that when they look at their population, by the time people hit about the age of 50, that probably five out of six people have met criteria for some type of diagnosis at some point in their lives. So psychiatric illnesses aren’t the other, they aren’t separate, they are us. Most people at some point in their life will struggle with something. And that doesn’t mean that they need to be hospitalized or on a medication. But it just means that they’d going through something that’s significant enough that it’s disrupted their ability to enjoy life, to do the things that are important, whether it’s work or relationships or just taking care of themselves. And the nice thing about a program like resolve is we can focus on those types of issues. We can also focus on whatever the stressor might be at any given time.

– You mentioned, if someone begins to feel overwhelmed, that’s a good time to call. What if it’s not you, but you say that you see it in a family member? What are some of the signs and the symptoms that could be warning signs that you should call and reach out for help?

– Right, so, you know, crisis is individual and the way it presents in one person may be different than somebody else, but things that might raise a few flags we want pay a little bit more attention: people crying more often than is usual, feeling like their emotions are out of control. Certainly if someone is feeling hopeless, making comments about feeling unloved or unlovable. Like they wish they could go to sleep and not wake up. And certainly if they’re talking about suicide, all times when we definitely want someone to reach out. But ultimately, the threshold is very, very low. And if someone you care about seems to be struggling, and you’re not sure where to go next or what else can be done to help them, then please just pick up the phone and call us at 888-796-8226. We’d love to talk with you, we’d love to talk to that person you care about, and figure out what we can do to help things go better.

– Right, and all cases are different, but typically, what’s the minimal amount of intervention and up to some of the most serious cases?

– That’s a great question. So typically, you know, we get a couple hundred phone calls every day into our phone center. An average call might be in the five- to 10-minute range and might be a couple supportive questions. We could share resources. Sometimes we’ll be on the phone with someone for quite a bit longer. We have mobile teams that go out, you know 30 to 40 times a day all across the county. Those interventions might be a little bit longer: you know, an hour or two is not uncommon. We have a walk-in program where people come in. Then we might support someone for three, four, or five, maybe six hours at a time. And sometimes if someone’s in a lot of crisis and needs that sort of supportive place to stay and maybe doesn’t have another supportive place to go, we can support folks for up to a couple days at a time at our crisis center.

– And so let’s talk about, we have already talked about from the patients’ side, how COVID-19 impacted care from the operation side. How did you operate as an institution in the middle of COVID-19?

– Right, so I would say our clinicians respond to the crisis of the consumer or the individual reaching out for help, and it’s sort of our administrative role, if you will, that’s responsible for the systemic crisis. And what can I say? COVID has been a bit of a systemic crisis. We have looked top to bottom throughout our program about what we need to be doing to make sure that our staff are safe, that we make sure that our consumers are safe, that we make sure that we’re responsible members of the community and keeping the community safe. That said, while we’ve modified a lot of our day-to-day processes, everything from temperature and symptom screening as people come through the door, masking, you know, asking specific questions about possible exposure before we’re sending a team out or having someone come into the building, ultimately, our operations are very much unchanged, to make sure that now more than ever, as our community really needs us, that we’re there and that we’re able to provide those services, and at the same time, respecting the safety and the health needs of our team as well as our community.

– And you use video visits as well.

– So we’ve done a couple extra measures throughout this crisis. One of them was providing the option of video support maybe as an intermediate measure or as an alternative to a home visit from a mobile team. And we’ve used a variety of sort of different technological tools to help people connect by video to some of our support staff. And whether or not we keep that in the long term, certainly, you know, as the COVID issue ebbs and flows, we may continue to reuse it. But we’re also hoping to use it as another way to make sure that as our team’s coming up to someone’s house, the family says, “Oh, wait, I recognize them, I’m a little bit more comfortable. Because it can be kind of scary to have strangers coming into your house, especially when you’re already dealing with a crisis.

– Right, and so ultimately, what message do you want to leave with people about calling and getting help if needed?

– If you or someone you care about is starting to feel overwhelmed, if you’re starting to feel like I’m not sure what to do next, if you’re just feeling like I need more help, that’s all the threshold it takes to pick up the phone and call us. We have wonderful staff standing by 24/7, 365, and we’re eager to find ways to help you and those you care about to get through this crisis or any other that you may be facing.

– Well Dr. Jack Rozel, some great information. Thank you So much for spending time with us today. We certainly do appreciate it.

– Thank you.

– I’m Tonia Caruso. Thank you for joining us. This is UPMC HealthBeat.

About Behavioral Health

UPMC Western Psychiatric Hospital provides high-quality, cutting-edge psychiatric and addiction services. We serve all ages of people at all stages of recovery. We provide diagnostic services and treatment for all types of psychiatric and mental health conditions. We serve more than 25,000 patients each year. Our hospital, in Pittsburgh’s Oakland neighborhood, has more than 400 inpatient beds. Western Psychiatric partners academically with the Department of Psychology at the University of Pittsburgh’s School of Medicine. Together they conduct research and clinical trials.