Nobody seems to know anything, and someone should. I decided to join a new nonprofit organization serving North Carolina, the Mental Health GPS, which provides what it calls navigation services. The idea is simple. You call the GPS, and we listen to the whole story. We collect basic data, like age, location and insurance coverage, if any. Then we search a bank of up-to-date databases and give you multiple appropriate, vetted options — therapists, clinics, detox programs, peer support or whatever is needed. If those contacts don’t pan out for some reason, you call back and get more. The service is confidential and independent.
The role of mental health navigator — of providing humane, knowledgeable guidance — has been around for decades, filled by the country’s therapeutic consultants, with fees from $100 to $350 an hour or up to at least $5,000 per quarter. In recent years, nonprofits like the one where I volunteer have emerged to provide a similar, less concierge-like service at no cost to anyone in need.
Our experience thus far has made it clear that any navigation service that scales up must have three components. One is a sophisticated tech back end, which even at a small operation like the GPS means search engine optimization to increase its visibility on the web and data-analysis algorithms. All of the basic data from our calls is stored and anonymized to guide us in analyzing trends and updating information on the services in the databases.
The second is databases that cover the full range of services and support. In contrast to many other directories, ours include many low-cost, nonclinical supports, like warm lines that offer callers emotional support from volunteers who are in recovery themselves and information on local AA meetings.
Finally, any decent navigation service should be about talking to people at a critical moment, exactly when they have summoned the courage to ask for help. It means not just a sympathetic ear but also informed context. “What’s with this diabolical behavior therapy, anyway? I don’t like the sound of it,” one caller told me. (I replied that it was called dialectical behavior therapy and explained what it was.)
At the end of the day and the beginning of the next, this is human work. No bot can do all this adequately and sensitively, and no A.I. program can ever simulate the experience of people who have been through the fire shower of a mental health or substance use problem. These people, known in mental health circles as peers, understand the system from the inside and the frustration of trying to find decent care. GPS call takers are mostly peers, people solidly in recovery who, in effect, are taking calls from versions of their former selves.
Over its first full year of operation, the GPS received more than 1,000 calls, some 800 of which were legitimate. (All call-in lines get some prank calls, bot calls and wrong numbers.) It’s a small sample thus far, from just one state. But these 800 calls begin to tell a story or at least provide a slightly blurred X-ray of the nation’s behavioral health needs in real time, day to day.