Birchstone hopes to bridge the gap; clinic in Vancouver will offer mental health urgent care starting this month

A person experiencing a mental health crisis often needs more support than a visit to the emergency room. A family of therapists in Vancouver aims to be that additional resource.

Birchstone Mental Health Urgent Care, 207 E. 19th St., opened to the community Tuesday. The family-owned urgent care clinic is designed to bridge the gap between traditional therapy and emergency room care. Birchstone will offer crisis intervention services on a walk-in and appointment basis for people experiencing panic attacks, suicidal thoughts, self-harm risks, behavioral changes and more.

Clinical psychologist Kelly Fielding has had a private practice in Vancouver since 1986. He noticed a lack of resources for people experiencing sudden mental health crises, and the emergency room isn’t always the place to go, he said.

“For about 25 years, I was also the crisis intervention guy for Clackamas County (Ore.) Health and I would get 40 calls a weekend from people in distress. In essence, they could go to an ER, go straight to a psychiatric unit or have the police come visit,” Fielding said. “What we’re trying to do is fill a hole where people can come and feel that they’re valued. That’s our purpose.”

‘Urgent care for the mind’

Birchstone Mental Health Urgent Care will operate separately from the family’s private practice, which is run by Kelly Fielding, his wife, Gayle, their son, Brandon, and their daughter-in-law, Kelli Dougal.

The four therapists will take turns running the urgent care clinic from 9 a.m. to 5 p.m. Monday through Friday. Each mental health urgent care visit will cost $150, but the clinic can offer sliding-scale payment options. The urgent care clinic will not accept insurance.

Once someone arrives at the clinic, one of the four therapists will conduct an assessment of the patient’s current situation. Then, that therapist will develop a plan to determine whether the patient may need to go to a psychiatric unit immediately.

The family will also provide resources, including referrals for social services and local therapists, medication management and case management. The clinic will offer up to three sessions of crisis intervention as a bridge while patients wait on a referral if needed.

Birchstone has connected with other local organizations, including Rainier Springs, Legacy Health, PeaceHealth and the National Alliance on Mental Illness Southwest Washington to brainstorm how to further reach the community.

“When someone commits their life’s work to something like this, it almost feels like a sacred commitment, and you really do want to see people feel better, feel more functional and capable and have better relationships,” Kelly Fielding said.

Lack of resources

Gayle Fielding said the idea for an urgent care mental health clinic took about a year to come to fruition.

The family agreed that the pandemic highlighted the reality of mental illness as many people felt isolated, distressed and hopeless. Coming out of that time period, they saw the need for that crucial step before someone resorts to the emergency room.

“As therapists, we deal with people in crisis, but we’ve noticed a big gap in what we can give them within a week or every two week sessions,” Brandon Fielding said. “But what if someone wants to hurt themselves? Their only real option is to go to the ER, and our ERs really just aren’t set up to deal with mental health. We want to give people a safe place to come, to feel heard and connect and put a plan together.”

Roughly half the population of the United States lives in mental health professional shortage areas, according to the Department of Health and Human Services.

The National Hospital Ambulatory Medical Care Survey, conducted by the National Center for Health Statistics, collects data on annual visits to emergency departments across the country. In 2021, nearly 6 million adults went to the emergency room for mental health care — an increase of 1 million from 2017.

But efforts from the state to increase access to mental health resources have taken shape in recent years.

“We have a lot of people in the community that hurt and are alone,” Gayle Fielding said. “If I break my wrist, I’m thrilled there is somewhere I can go immediately that can help me be out of pain. That’s what this work does — it’s the same thing but emotionally.”