Liz Unruh, (Host): Hello listeners, and thanks for tuning into the Well Within Reach podcast, brought to you by Riverside Healthcare. I'm your host, Liz Unruh, and joining me today is Rachel LaGesse, who is the Director of our Outpatient Behavioral Health here at Riverside. And today we're going to be talking about the mental health support services that we have beyond the hospital walls.

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Host: And we're back. Thanks for joining us today, Rachel.

Rachel LaGesse, MSW, LCSW: Thanks for having me, Liz.

Host: So before we get into the topic that we have today, would you be able to tell us a little bit about yourself? I know this is not your first time on our podcast, but just as a reminder for listeners.

Rachel LaGesse, MSW, LCSW: Sure. So I am the Director for Outpatient Behavioral Health with Riverside. I'm also a licensed clinical social worker and have been in the field for approximately 20 years.

Host: So you have a lot of experience in the realm of outpatient services that we have here.

Rachel LaGesse, MSW, LCSW: Yes.

Host: Great. So, to start off, can you just give us like a broad overview about what outpatient behavioral health is and how it's different from inpatient care?

Rachel LaGesse, MSW, LCSW: Sure. So outpatient behavioral health is the partial hospitalization and intensive outpatient program. So the biggest difference between those two services has to do with a client's treatment needs. It drives how many treatment hours that client needs a week in services. When they're engaged in treatment, it is all group therapy services facilitated by a master's licensed clinician, and then they also will see one of the Riverside Psychiatrists on a weekly basis as well. So an inpatient stay, the client does not go home for the day, obviously, they would stay at the hospital, which is very different from outpatient.

So a client may be in treatment, five hours a day, but then they go home and return to services when they're scheduled for services next.

Host: Okay. Yeah, that's definitely, the very big difference. You either go home or you're inpatient and you're staying overnight. So Riverside offers a few different types of specialized outpatient programming. Can you talk about those and how they're tailored to meet, some of those diverse needs of our community?

Rachel LaGesse, MSW, LCSW: Absolutely. So Riverside has two behavioral health school liaisons. These ladies are also licensed clinicians. They provide services directly into nine of our local school districts, so individual and group therapy. They've also provided training for educators as well as parents just based on the school's need.

Host: Yeah, that's a really cool program and kind of gets the name out there and shows them some of those coping skills or things that they could need in the school setting. So Can you walk us through what someone might expect when they enter one of the outpatient programs that we have for the first time?

Rachel LaGesse, MSW, LCSW: Absolutely. So we have primary clinicians. Our outpatient program is called Pathways. So a pathways clinician would meet with the client on their first day. We'll discuss services, go over consents. And then work with the client on assessing what their treatment needs are. So what current mental health symptoms are they experiencing and assessing for the impact that that's having on their daily functioning.

Host: Okay, so they've decided, if they want to come to services, that's how they would enter it. But what types of individuals or situations might make somebody a good fit for our Pathways program?

Rachel LaGesse, MSW, LCSW: Sure. So anybody who's struggling with mental health symptoms that are impacting their daily functioning, so whether that's work, school, it's having an impact on their sleep. Outpatient services are also beneficial for clients who are stepping down from a higher level of care. So that could be an inpatient hospitalization or residential treatment. And then last, outpatient can also prevent a future hospitalization for a client.

Host: Yeah, that's really big. We talked about like what they might expect when they enter and why they might be a good fit, but how do you determine which type of program the IOP or the PHP is good for a client?

Rachel LaGesse, MSW, LCSW: So it depends on the client's acuity of symptoms as well as our groups are divided with different ages, so obviously if you're a child you wouldn't be in adult programming. And then also based on some treatment needs. So in our adult programming we also offer dual, so that is addressing clients who have mental health concerns as well as substance abuse concerns, and we also have an all female adult trauma specific group. So again, just based on what the client's presenting treatment needs are, would drive what cohort they would be best suited in.

Host: Yeah, I think that's important. Being with people that are going through something similar so that you can relate is definitely huge.

Rachel LaGesse, MSW, LCSW: Mm-hmm.

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So back to our programming. We talked about the different programs a little bit, but are there age specific or condition specific programs, like services tailored to youth or older adults? I know you mentioned the trauma group.

Rachel LaGesse, MSW, LCSW: Mm-hmm. Yep. So our program is also divided, age specific. So our child group is from seven to 11 years of age. Adolescent services start at the age of 12 to the age of 17, and then adults are 18 and older. And then as I mentioned before, just depending on what the client's treatment need is, if they're struggling with substance abuse as well as mental health symptoms, they would be appropriate for our dual group.

Host: I think that's really important, knowing that we have different age groups that you're not seeing a seven to 11-year-old in with, like the older group. I think it's important that it's all age, age relevant. Let's talk a little bit about timelines. How long do the outpatient programs typically last? Is there like a progression through the program?

Rachel LaGesse, MSW, LCSW: Sure. So an average length of stay, in outpatient is typically three to four weeks. Now, that can change based upon the client's engagement in treatment as well as their treatment needs, when they first start services. We do meet with our psychiatrist on a weekly basis to talk about client's progress, and that really helps determine when they are ready for discharge as well as what will the next steps be upon discharge. So, possible referrals for individual therapy, continued with medication monitoring with the psychiatrist, whatever their needs are.

Host: Yeah. And you kind of touched on my next question. So you make sure they touch base with medication management or the psychiatrist. But are there other ways that you and your team work with the other providers across the Riverside Care continuum to make sure that care is continuous and coordinated?

Rachel LaGesse, MSW, LCSW: Yep. I would say most with the psychiatrists with Riverside. So, a lot of our clients will then have follow-up care once they complete services with us. That's not to say that everyone has to be on medication to receive outpatient services. It's something that we offer and evaluate for. And so if they are started on medication that's beneficial, they will have follow up with one of our Riverside psychiatrists.

Host: I think that's great that there's that continuation of care, and that continuity to make sure that we're not just dropping off. Because mental health is one of those things that's just an ongoing struggle for a lot of people. If someone we know is struggling or know someone that could use this type of support, what's the referral process look like? Do they have to go to a primary care first or can they self-refer?

Rachel LaGesse, MSW, LCSW: So clients can actually self refer to our program. You can reach out to Pathways directly at 815-936-7373, and a team member will talk about services with that person, screen for appropriateness, and then work to get them scheduled.

Host: That's great and definitely a great resource for people if they know someone that is struggling. And my final question here. What do you wish more people knew about the Pathways program or our outpatient behavioral health in general that might reduce the stigma or encourage somebody to take the first step?

Rachel LaGesse, MSW, LCSW: Knowing that you're not alone, that your mental health is just as much as a priority as your physical wellbeing is, and that we have a great staff team that's here and available to help.

Host: I think that's the best words of advice anyone could give for someone that is struggling with a mental health situation. Well, thank you, Rachel, for joining us today.

Rachel LaGesse, MSW, LCSW: Thanks for having me.

Host: And thank you listeners for tuning into the Well Within Reach podcast brought to you by Riverside Healthcare. To learn more about Riverside Behavioral Health, visit riversidehealthcare.org.