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.

In 2022, Washington launched the 988 crisis line as part of a national effort to improve the response to suicide and mental health crises. The 988 crisis line is confidential, free and available 24/7, and immediately connects a person to a team of trained counselors.

Since the launch, as many as 8,600 people call a month, and another 2,100 people text the lifeline.

Clark County Public Health also offers behavioral health crisis services that are available 24/7 through the Southwest Washington Crisis line at 800-626-8137.

Gayle Fielding said the family looks forward to expanding its clinic, and will continue to listen to better understand the needs of patients and the community.

“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.”