New provider offers urgent mental health services

Editor’s note: this story mentions suicide and suicide prevention. The national suicide and crisis lifeline is available by calling or texting 988.

WASHINGTON — It’s not usually clear what Elley Mohling will do with the bulk of her day as she walks through the doors of the McCreedy Medical Clinic and WCHC.

She has an outline, at least. As a crisis and transitional care liaison, she can usually expect about three planned appointments in the morning. That’s usually followed by efforts to connect patients with some other medical providers. Occasionally, she has administrative meetings, or somewhere specific to be, but for the most part, the plan changes at the drop of a hat.

“Things pop up, and I have to pivot,“ Mohling said. ”There’s times when I’m walking down the hallway and a coworker will be like, ‘Can I talk to you for a second?’ And then they’ll either share something about themselves or maybe someone else they’re concerned about, then that changes a little bit of what my day is going to look like.“

There’s a lot of variety in what a response by Mohling entails.

Many times, she’s summoned to help patients de-escalate from a pressing mental health crisis. Others, called when a WCHC client needs urgent help, but cannot get to their therapist in short order. Mohling also helps fellow hospital employees work through their own challenges.

Another major aspect of her job is following up with patients shortly after they’ve checked out from inpatient psychiatric care. That typically happens the first day after they’re discharged, and again a week after that. For people facing mental health hurdles, it’s among the most high-risk periods.

For many, the checkup is essential. It has saved lives.

“I really just want to help people be safe, be healthy, continue to live,” she said. “You’ll never forget the first time someone says to you, ‘You saved my life.’ I remember the first time that was said to me, and on the days when it’s really hard, or I’m really tired, maybe I have something really stressful, I think of the times I’ve heard that. It’s my motivation.”

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It takes small steps to recover from such a crisis, according to Mohling. She said for many clients, safety plans start with a question: “What will it take to stay alive until tomorrow?”

The reach extends a little further with each conversation. She asks what it would take to stay alive for another week, then a few weeks, then longer. When things go awry, patients can call her and get appointments fast, on account of the flexible schedule.

Mohling is the first to hold her position at WCHC. The hospital already had two nurses specialized in mental health care when she started in August, and much of her job boils down to helping them handle their own heavy case loads, or responding to clients with needs more dire than other providers’ schedules can accommodate.

“There are so many people in our community that are in need of support,” she said. “And in such a rural area like this, there can be barriers — transportation, finances — to get help outside of Washington, so we really started to become a hub of this mental health need.”

Patients are typically not billed for Mohling’s services. While she has master’s degree in psychology, she’s not licensed therapist, and her work cannot show up on an invoice for mental health counseling.

As a result, the provider can work somewhat outside of the financial system of modern health care. Mohling responds to crises even when patients don’t know her services exist, and can help others while they linger on other professionals’ waitlists, or navigate lapses in insurance coverage.

“It was a goal to make sure that everybody could have that support,” she said. “In my mind, I didn’t want it to be billable because I never want the burden of payment or insurance to be the barrier that prevents someone from seeking or utilizing support and, ultimately, living.”

The work, while rewarding, comes with mountains of pressure. It’s understandably stressful.

Mohling’s modest office is a fairly relaxed space, decorated with a small desktop fountain in the corner, a desk, and shelves of tasteful artificial plants, many of them built from floral-themed LEGO sets.

Despite the calm workspace and love for the job, it’s still important to take breaks, and keep her own mental health in check.

When she needs to do that during the day, Mohling goes for walks through the hospital, where she says the movement helps clear her head. After hours, she takes comfort in time with her family, but sometimes has to set a boundary when she’s — in her words — “done people-ing” and needs her own space.

“On those days, I’ll get in the car, and loud music is my friend,” Mohling said. “And sometimes it is calling my husband and just talking to him, not even about work … I’m really listening to myself, and trusting myself that I know what I need. I think that’s the biggest part, is being really in touch with who you are, with what is important to you, and what you need, and being willing to advocate for that.”

Comments: Kalen.McCain@southeastiowaunion.com