So watching people come in from a place of maybe feeling a little bit hopeless and helpless to empowered with the tools that they need, it just never gets old. It's great work.

Hello and welcome. I'm your host, Bill Emeiser, and you're listening to Mental Health U, the podcast dedicated to demystifying and destigmatizing mental health issues. So if you or someone you know is struggling with depression, anxiety, trauma or some other mental health issue, then this podcast is for you. This episode is proudly sponsored by Unison Health, dedicated to making lives better through compassionate, quality mental health and addiction treatment services. Learn more at unisonhealthorg. I am super excited.

Today we have Mandy Sattler, the program manager of the Crisis Stabilization Unit in Wood County. She's here on the podcast. She is an experienced RN. She brings a wealth of knowledge, both physical and mental health disciplines. Her leadership at the CSU is invaluable and she is playing a pivotal role in providing vital mental health services to the Wood County Northwest Ohio community. Mandy, thank you so much for being on the show. How are you, Hi Bill, it is my pleasure to have you on the CSU, the Crisis Stabilization Unit. It is a new service. I think it's needed and my hope is to pull back the curtain and let you talk about all the things that are going on there in Wood County with the CSU. But before we do that, could you maybe start by telling us a little bit about your professional experience?

Yeah, so I've been a registered nurse for 17 years. I've worked predominantly in the hospital, setting in multiple roles. So I was a bedside nurse for the bulk of those years and then, more recently, before coming to Unison, I was leading outpatient services at the hospital. In that time frame I started to notice some gaps in care and noticing that the mental health needs of my clients weren't being met. So I had gone back to school to pursue mental health. And then I was so blessed that this facility, the CSU, opened up right in my community and I was able to be part of that as a nurse when it opened.

What is the CSU? What is the Crisis Stabilization Unit?

The Crisis Stabilization Unit is a class three residential facility and our primary goal is to treat clients that are experiencing a mental health crisis in the least restrictive environment as possible, so in a more like home-like atmosphere that allows visitors and just a more comfortable setting to work through what you're going through.

What makes the CSU different than a traditional hospitalization for mental health issues?

Yes, I think one of the biggest things is there's a wide range of conditions and situations that people can come in for you don't have to be in such an extreme crisis that maybe you're suicidal. We see folks that are maybe having their first bout of mental health symptoms or just had an extreme life event that is a little more than they can handle in that moment, all the way up to somebody who is maybe suicidal. So I always like to use the medical term. Imagine that with me being a nurse. But I consider it a step down from the ICU. You have the critical care unit and then you have that step down unit. That's that in between. I consider us like the bridge between inpatient and outpatient treatment.

You're a bridge between those two levels of care.

So somebody comes in levels of care, so somebody comes in what's the typical point A to point B for you at the CSU and your staff there. First and foremost, client safety is always the first goal. If you are experiencing suicidal ideation, our goal is going to be to take that risk away. Keep you safe. Make sure that you have the resources that you need so that's always our top priority. Make sure that you have the resources that you need so that's always our top priority. Other things are to just help deescalate you out of that crisis, and my favorite part about working at the CSU is to empower people. So watching people come in from a place of maybe feeling a little bit hopeless and helpless to empowered with the tools that they need, it just never gets old. It's great work.

So what type of interventions, what kind of services do you?

provide to bring that change about. Yeah, so a client that gets admitted to the CSU is going to meet with a therapist individually each day, sometimes more if needed. We have two group sessions each day. One's a little bit longer than the other. We call it our day group and then we have more of an enrichment group in the evenings and then you will see our provider regularly to do medication management. Something unique about the CSU is we always have medical staff. We always have nurses on the unit, so you'll get that assessment. We'll help you go through, support you through some of the physical changes that happens when you start medicine or change medicine too, so that will be available to you. We also have great peer support, which is an individual who has walked this journey before and can provide that perspective. And we also have an SUD, our substance use navigator, that can help folks that are looking for treatment after they leave get connected with that too. So we have a holistic service for everyone.

Yeah, it sounds like you really do. You've covered all the bases. I'm thinking, if I'm maybe I'm experiencing a mental health crisis and it's, I don't know, three in the morning on a Thursday and I'm experiencing a crisis, what do I do to? And I'm in Wood County. I think that's important, right? So this is a service that is for it's funded by the Wood County Mental Health Board, and so it is for residents of Wood County. But let's say I'm experiencing a mental health crisis, it's early morning, what do I do? How do I get to the CSU?

There are a couple of ways. We'll start with the scenario that you described. Three in the morning, you don't know what to do. We have the crisis line, or hope line that we call it here in Wood County. You can call that directly. It's 419-502-HOPE.

You will get to speak to someone. They will be trained and they will be able to talk you through what's going on and assess what the best thing is for you and can ultimately get one of our mobile crisis response team members right out to your home. At that point they can screen you and if it's a good fit for you to come to the CSU, we can arrange for you to come that way. Another option is you can actually just come right to the CSU Day night, 24 hours a day. We accept walk-ins and we'll be happy to talk with you. I just want everyone to know that this is we are not judging you and that everyone's experience is valid. So I encourage you if you're having a hard time, come and chat with one of us. We can help you and there will be no judgment.

And what are the things that I keep hearing about the CSU, and I'm just thinking of some of the students. So we have a college there, at BG. It's good old BGSU.

Bowling Green State University Go Falcons, yeah, go Falcons.

And I know that the CSU is utilized by the students there. One of the things that makes this program different, I hear, is that you are able to accommodate students in their needs and not just students but anyone there in the community if they're part of the CSU that under certain circumstances they can get those services, get that support and say they have an exam. Is it true that they could maybe go do that exam and still come back? That it's not like an all or nothing, that? No, now that you're in the CSU, you can't leave the CSU. You have to stay here the whole time. If you had some kind of life event like an exam or an appointment, is there that flexibility built into the CSU?

Yeah, there is some flexibility. So what we do is we take it case by case, but I'll start with the students, for example. So we have a and one of the big stresses for students when they are struggling is oftentimes their coursework. With the appropriate arrangements we're able to let you continue to work on homework A lot of times. We're able to get those things moved around for you without it impacting grades, that sort of thing. As far as leaving the unit if mostly that's for like physical health, sometimes there's some legal involvement, those sort of things we make best efforts to make those things continue on those sort of things. We make best efforts to make those things continue on. And that just goes back to if you are struggling and then those things start to pile up. That doesn't help. So we're really fortunate that our staff here arrangements offer support and keep some of those things moving. Yep.

That's awesome. How long is the typical stay at the CSU?

Typical stay. We say three to five days. Usually a couple weeks is around the max. It's individualized. For some people a couple days stay is just what we need we get on our way and outpatient treatment. For other people maybe there's some more complex things going on. We never just kick anyone out. It's really case by case.

Mental Health U is brought to you by Unison Health. Unison Health, making lives better. What about aftercare? What happens when somebody leaves the CSU? They're stable or have been stabilized so they don't need that high of a level of care. What comes next? What's the aftercare look like?

I think that's something we do really well here at Unison is not only treating you but making sure that you get what you need ongoing, so that you can be successful. Before you leave the unit, we're going to find out what your wants and needs are, which group you'd like to follow up with for your treatment, and it doesn't matter who you choose. We're going to help you get connected. So we make sure if you're having therapy, we will make sure you have those appointments, medical appointments we have wonderful groups here at Unison. We make all of those arrangements before you leave and then a day or so after you have left, you'll get a call from our peer, liam, who's going to make sure that you're still doing okay and that you still have those appointments, and then we will follow with you from there. If you have some ongoing case management needs, we also can help you with that. We will continue to do that as long as needed to make that transition from being with us to the outpatient setting.

It's so it sounds like you don't have to be a client of Unison to access the CSU.

No, it is open for everyone, something you said earlier. It is primarily, especially if you're going to use our crisis line for Wood County residents. However, we do often see folks that have been referred from out-of-county agencies or other mental health agencies as well Say maybe you are hospitalized in the inpatient psychiatric unit. We also are able to step you we call it stepping you down have you come to us and help you make that transition home. There are some unique things we can do as well with that.

So how does that work? So, if I'm in an intensive inpatient hospitalization, maybe it's even involuntary, but and we'll help you connect with resources, just like I just described with the CSU.

If you're not ready to go home but this is no longer the place for me or the doctor saying, okay, we feel you're doing well, but not quite ready to go home, they can make a referral. You can make a referral or you can just come in after you left they can make a referral.

You can make a referral or you can just come in after you left. We have a referral process on our website that we will coordinate care directly from the hospital. And then we've had a couple of folks that have come home and been like I'm still not quite feeling well and walked in and we took them right in.

There's no wrong door.

All are welcome.

I would assume that, while this is a very rewarding job, it takes a lot of traits and qualities to be a good provider in a CSU. What are some of the challenges that you and your staff experience?

Yeah. So first, I think I want to say that this work is such meaningful, important work and we're very passionate about it. But it can be tough work at times, Just helping people in some of the worst times of their lives. It can be difficult, so we're always looking for people to come work at the CSU. We have physicians available for nursing, therapists, case managers available. If you're interested in that, please reach out to us. You can go to our website and there's more information there.

Yeah, I think it's dot org forward slash careers and then when you click on the learn more there you can find all kinds anything that says csu right at the front of it is a csu position and it sounds like there are some openings there, so that is fantastic. We've talked a little bit about how you get into the program with the program is what happens after the program? Let's say there's somebody out there right now that's interested in learning more information about the CSU. Where could they get that information?

So there's information on our website. If you go to unisonhealthorg forward, slash CSU, there will be more information for you there.

Awesome, Mandy. I really appreciate you spending this time sharing all this information about the CSU. It sounds like incredibly rewarding and important work, and so I want to. For somebody who lives in the community, I want to thank you for all that you're doing and the services that you're providing to our community. You're making lives better.

Absolutely Thanks for having me.

This podcast has been brought to you by Unison Health. Unison Health is a nonprofit mental health agency dedicated to serving the Northwest Ohio community for the past 50 years.