Telepsychology resources growing in upstate NY
Nancy Gerlach’s kitchen was a flurry of chopping and mixing. Pots steamed on the stove, and bowls and Tupperware filled the counter space in her Finger Lakes home.
“We’re up to our elbows,” she said.
It was a weekend of mixed emotions. Her son Bill and his fiancée were expecting a baby.
And another son, Derek, was dead.
The baby shower and the burial of Derek’s ashes were scheduled for the same day.
“We are moving from sadness to joy,” she said.
Derek died of an opioid overdose during the same time thatBill, who’s had addiction struggles of his own, was developing an app that he said might have saved his brother’s life.
“That’s the hard thing,” Bill Gerlach said, his voice catching in his throat. “If we’d got this going, he could have been alive today.”
Gerlach’s app is called HereNOW Help. It’s like Uber, he said, but for mental health. Users will log in and tell the app what sort of support they’re looking for, and it will show them nearby people who can offer those services.
The key is that those people will be available outside of regular office hours, Bill said. Issues like addiction don’t follow a schedule, so he wanted to find a way to connect people 24 hours a day.
“I found that out the hard way,” said Gerlach. “I was detoxing. I went through it myself. Your most vulnerable times could be at three in the morning. You’re by yourself, the room’s closing in, you can justify relapsing in two seconds.”
The app has become a family business. Nancy is the chief financial officer. His uncle, John Brennan, is a professional therapist in charge of recruitment and training.
Most of the people on the app won’t actually be counselors, Brennan said. Their role will be more like trained listeners.
“They’re simply there to be a paid friend,” he said -- to talk, or to let clients vent. “They’re trained only in how to listen with empathy, without advice.
Gerlach said that getting those people certified as counselors would be prohibitively expensive. And Brennan said that his own struggles with alcoholism have shown him that a lot of the time, people just need a listener.
“I know people who come into (Alcoholics Anonymous) who’ve got incredibly powerful cravings. They go to an AA meeting, and for that one hour, great, they’re OK. But they step outside, and immediately the cravings hit them again,” he said.
Brennan said he’s gone through lists of people on his phone, trying to find someone to grab coffee with just to take his mind off drinking. And sometimes, no one’s available.
“We’re there for the other 23 hours a day, when you don’t have a meeting with a professional,” said Brennan.
The business is based in Honeoye, a hamlet of about 600 people in a rural area of Ontario County. Brennan and Gerlach said that’s intentional: Like many rural communities, it’s underserved by traditional counseling services.
But the same problem of people who lack options for mental health support also exists in urban areas. Gerlach said they'll test the app in New York City, as well.
Meanwhile, Caroline Easton is leading federally funded research at the Rochester Institute of Technology.
Easton, a professor in RIT’s behavioral health division, said she’s looking to connect people who are homeless with psychologists and psychiatrists.
“Many of them lack insurance, don’t have money, don’t have cars or transportation to make it to the different sites that offer more traditional approaches to mental health,” Easton said.
There’s a shortage of psychologists and psychiatrists locally who are familiar with tele mental health, she said. Her funding includes incentives for interns to learn and stay in the Rochester area.
But like the app developers, Easton said technology is only part of the picture. Ideally, she said, clinicians will develop a connection with their client in person, before moving to telepsychology.
That model is a good one, said Gerard Lawson, a professor of counselor education at Virginia Tech and past president of the American Counseling Association.
Lawson said tele mental health has been effective at reaching people who would have a hard time getting to a traditional clinic.
“We want to create a situation where there’s no wrong door into treatment. If someone wants a counselor, we want it available and accessible to them,” he said.
Still, he said, there’s a lingering bias in his field toward face-to-face meetings.
“Full disclosure, I still share in that bias that, in my estimation, there’s something valuable about being in a person’s presence,” Lawson said.
“Hearing the very minor changes in their voice, and hearing the changes in how they’re breathing, even, is all information that I can get when I’m in their presence, and may or may not with distance technology,” he said.
Lawson said both the Gerlachs’ app and Easton’s research sound like promising ways to get mental health services to more people.
Easton said her project is just getting started. Gerlach said the HereNOW Help app is set to start pilot testing in January.