Mental Health Urgent Care: Bridging the Gap in Crisis Care

Published on June 30, 2025

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Urgent Message: Meridian Health’s Mental Health Urgent Care service addresses the gap between outpatient therapy and hospitalization. As a way to improve access in communities, this model also provides cost savings and convenience for clients.

Katie Nolin, MSc, LMFT, LCADC

In 2024, Meridian Health launched its Mental Health Urgent Care service to address a critical gap in mental healthcare: the space between outpatient therapy and hospitalization. Since the program’s inception, we’ve served 39 clients, primarily addressing depression, anxiety, and addiction. While these numbers may seem modest, they reflect a broader, more complex story about how our community engages with urgent mental healthcare and the challenges that persist in making such care feel both accessible and acceptable.

A New Model for Mental Health Crises

Our Mental Health Urgent Care operates Monday through Friday from 7 AM to 7 PM, and on weekends by appointment, with a staff of licensed clinical social workers, marriage and family therapists, certified professional counselors, and contracted psychiatric medication management professionals. Patients can walk in or schedule same-day appointments, with intake involving a brief triage to assess urgency and needs.

This model allows us to see clients daily until: stabilization occurs; a higher level of care—such as acute psychiatric care or residential treatment—is available; or their established provider—who may be booked 2-3 weeks out or more—can accommodate them. Hourlong visits are capped at $300. We accept most major insurance plans, ensuring affordability. Without insurance or other funding, 3 visits in our urgent care cost $900, and a full week that includes 5 visits (Monday through Friday) costs $1,500. This is significantly less than other care settings.

• A 72-hour psychiatric “hold” in an emergency department (ED) before admission or discharge can cost $9,000-$24,000 for those without insurance and $500-$5,000 out-of-pocket for those with insurance.
• One week in an acute psychiatric hospital can cost $8,400-$17,500 for those without insurance and $1,000-$5,000 out-of-pocket for those with insurance.

Beyond cost savings, our model reduces the anxiety and negative associations many patients experience with ED holds or inpatient admissions, offering a less intimidating alternative for crisis care. For example, a 21-year-old male presented to us in March 2024 with a severe anxiety attack as defined by his Generalized Anxiety Disorder-7 (GAD-7) score of 20. He also had suicidal ideation without intent to attempt suicide, plus distress over his job demands and his justice-system probation status. He had stopped taking his mood stabilizing medications (lithium and lamotrigine). After 4 urgent care sessions, his anxiety lessened to a GAD-7 score of 10, he resumed his medication, and he successfully completed probation, avoiding a situation that might have otherwise resulted in hospitalization.

To guide patients and providers, the following table outlines situations for behavioral health urgent care vs ED care.

This framework ensures patients receive care in the most appropriate setting, helping to differentiate EDs or acute psychiatric hospitals as care settings for life-threatening conditions while leveraging urgent care for acute mental health crises.

The impetus for launching Mental Health Urgent Care came from stark observations: EDs are often overwhelmed with mental health cases that don’t necessitate hospitalization, while outpatient therapy can have weeks-long waitlists. Community resources like the 988-crisis hotline provide critical support. However, many callers need more than telephonic intervention—they need face-to-face care. Meanwhile, local behavioral health resources, such as community clinics, are often stretched thin, and recent cuts to funding for these programs have left gaps in access. Our urgent care model fills this void, offering a same-day, in-person option that stabilizes patients and connects them to ongoing care.

Societal Disconnect in Prioritizing Mental Health

Despite growing awareness of mental health, we’ve observed that individuals often reach out in crisis, only to decline scheduled appointments due to conflicts with personal appointments or errands, for example. This isn’t about trivializing their needs—many express genuine distress but struggle to prioritize mental healthcare in the moment. It reflects a broader societal disconnect: the concept of urgent mental healthcare, outside the extremes of therapy or hospitalization, remains unfamiliar. For some, the idea of seeking help without being admitted feels uncomfortable or unnecessary, revealing a need for greater education about what urgent mental healthcare can offer.

This disconnect extends to the insurance industry. Currently, 4 commercial insurance companies allow Meridian Health to contract and bill urgent care codes, but many insurers fail to recognize the critical need for this level of care. In 2019, when our organization met with UnitedHealthcare and Blue Cross Blue Shield to discuss this model, they advised us to prove that their insured members needed this service. This stance ignored the mental health landscape at the time and its dramatic worsening since the COVID-19 pandemic.

In 2019, approximately 20.6% of U.S. adults (~51.5 million) had any mental illness, and 5.2% (~13.1 million) had serious mental illness. At the same time, 14.0% of youth (~3.4 million) experienced major depressive episodes. Additionally, 24.7% of adults reported unmet treatment needs, according to federal data.[1] Suicide rates were climbing (14.2 per 100,000), and ED visits for mental health issues were rising during the pandemic years.[2]^,[3]

Since the pandemic, the mental health crisis has intensified. Anxiety and depression in adults spiked with 30-40% reporting symptoms during 2020–2021 (from ~11% pre-pandemic).[4] More than 42% of high schoolers reported persistent sadness or hopelessness, and ED visits for teen girls’ suicide attempts increased 50.6% in early 2021 compared to 2019.[5]^,[6] Substance use disorders escalated with overdose deaths exceeding 106,000 annually by 2021.[7] By 2022–2023, adult mental illness prevalence rose to 23% (~59.3 million), youth mental health remained at crisis levels, and demand for services continues to outstrip supply.[8] The insurance industry’s reluctance to cover mental health urgent care may be considered a disservice to members, as mental health needs have grown in severity, prevalence, and complexity, especially among youth, marginalized populations, and healthcare workers.

This lack of support also underscores challenges in health equity when considering how often underserved populations face systemic barriers to care. We have created valuable relationships with local partners like Safe Embrace and the Intertribal Council. These partnerships have been vital to our success, enabling us to provide free or low-cost services to those who might otherwise fall through the cracks.

Safe Embrace connects us with individuals escaping domestic violence, who often need immediate mental health support to address trauma and anxiety, ensuring they receive trauma-informed care in a safe environment. The Intertribal Council facilitates culturally sensitive care for Native American clients, incorporating traditional practices and community-specific solutions into our services. Our model also allows those in rural areas, where mental health resources are scarce, to access care that would not otherwise be available to these populations, bridging geographic and systemic gaps. These collaborations not only sustain our model but also amplify its reach, ensuring care is both accessible and tailored to the unique needs of our community.

Lessons for Urgent Care Providers

As urgent care providers consider integrating or referring to behavioral health urgent care models, several takeaways emerge.

1. Fill the Gap with Specialized Care: Mental Health Urgent Care addresses a critical need for immediate, in-person support that bridges outpatient and inpatient care. Providers can refer patients in crisis to such services, reducing strain on EDs.
2. Educate Communities: Public hesitation to engage with urgent mental health care highlights the need for outreach. Urgent care centers can play a role in normalizing same-day mental health services through community education.
3. Leverage Partnerships: Collaborations with community organizations are essential for sustainability and equity. Partners can provide funding, referrals, and cultural expertise to enhance care delivery.
4. Prioritize Accessibility: Capping costs and offering flexible scheduling make care approachable. Urgent care providers entering this space should ensure affordability and ease of access to attract hesitant patients.
5. Develop Tailored Programs for High-Risk Populations: Urgent care providers should create individualized, programmatic approaches for groups such as those supported by victim services and those frequently involved in the justice system. Understanding the unique needs of specific populations can lead to urgent care programming—such as trauma-informed care or flexible scheduling—that promotes access and reduces recidivism.

Meridian Health’s Mental Health Urgent Care is a vital step toward redefining how our communities access mental health support by delivering immediate, compassionate care to those in crisis. The escalating mental health crisis demands action. Urgent care providers must advocate for universal insurance coverage of mental health urgent care codes, while demonstrating the cost-effectiveness and efficacy of this model to insurers. By forging partnerships with local organizations and piloting similar programs, providers can ensure that no one in crisis is turned away, transforming urgent care into a cornerstone of mental health equity and access.

References

1. [1]. Substance Abuse and Mental Health Services Administration. Key Substance Use and Mental Health Indicators in the United States: Results from the 2019 National Survey on Drug Use and Health. HHS Publication No. PEP20-07-01-001. Published 2020. Accessed June 5, 2025. https://www.samhsa.gov/data/sites/default/files/reports/rpt29393/2019NSDUHFFRPDFWHTML/2019NSDUHFFR090120.htm
2. [2]. Centers for Disease Control and Prevention. National Vital Statistics System: Mortality Data. Published 2021. Accessed June 5, 2025. https://www.cdc.gov/nchs/nvss/deaths.htm
3. [3]. Cairns C, Kang K. National Hospital Ambulatory Medical Care Survey: 2021 Emergency Department Summary Tables. CDC National Center for Health Statistics. Published 2021. Accessed June 5, 2025. https://www.cdc.gov/nchs/data/nhamcs/web_tables/2021-nhamcs-ed-web-tables-508.pdf
4. [4]. Panchal N, Kamal R, Cox C, Garfield R. The Implications of COVID-19 for Mental Health and Substance Use. KFF. Published 2023. Accessed June 5, 2025. https://www.kff.org/mental-health/issue-brief/the-implications-of-covid-19-for-mental-health-and-substance-use/
5. [5]. Centers for Disease Control and Prevention. Youth Risk Behavior Survey Data Summary & Trends Report: 2013–2023. Published 2024. Accessed June 5, 2025. https://www.cdc.gov/healthyyouth/data/yrbs/pdf/YRBS_Data-Summary-Trends_Report2023_508.pdf
6. [6]. Yard E, Radhakrishnan L, Ballesteros MF, et al. Emergency department visits for suspected suicide attempts among persons aged 12–25 years before and during the COVID-19 pandemic—United States, January 2019–May 2021. MMWR Morb Mortal Wkly Rep. 2021;70(24):888-894. https://www.cdc.gov/mmwr/volumes/70/wr/mm7024e1.htm
7. [7]. Centers for Disease Control and Prevention. Drug Overdose Deaths in the United States, 1999–2021. Published 2023. Accessed June 5, 2025. https://www.cdc.gov/nchs/data/vsrr/vsrr022.pdf
8. [8]. Substance Abuse and Mental Health Services Administration. Key Substance Use and Mental Health Indicators in the United States: Results from the 2022 National Survey on Drug Use and Health. HHS Publication No. PEP23-07-01-006. Published 2023. Accessed June 5, 2025. https://www.samhsa.gov/data/sites/default/files/reports/rpt42731/2022-nsduh-nnr.pdf

Author Affiliation: Katie Nolin, MSc, LMFT, LCADC, Meridian Health, Reno, Nevada.

Read More

• Evidence Mounts That Urgent Care May Have a Place in the Ongoing Mental Health Crisis
• Mitigating Suicide Risk in Young Patients: Urgent Care’s Role in Identifying Patients At-Risk And Saving Lives