New mental health clinic aims for faster care
Psychiatric nurse practitioner Paul Fickes has opened a walk-in mental health clinic in Medford after seeing a need for faster appointments.
Before he opened Paradigm Mental Health and Wellness earlier this month, he was a psychiatric nurse and then a psychiatric nurse practitioner in the acute psychiatric unit and emergency department at Asante Rogue Regional Medical Center.
When he would help make discharge plans for patients, waiting times to get follow-up mental health care out in the community stretched from a few weeks to months.
“That is a time when patients are most vulnerable to relapse and having another episode,” Fickes said.
Without care, a person who’s suffering from suicidal thoughts, for example, is at risk of attempting suicide after discharge, he said.
Through his new clinic, Fickes wants to provide the quick care patients need.
He recently had a patient call and ask whether any appointments were available at Paradigm Mental Health and Wellness.
“The person came in 15 minutes later,” he said.
For now, the clinic is a one-man show with Fickes providing all the care during business hours from 9 a.m. to 6 p.m. As his practice grows, he plans to bring a receptionist on board, plus his wife, who will be able to provide therapy as a licensed clinical social worker.
After hours, patients are referred to Jackson County Mental Health’s 24-hour crisis line, which serves anyone regardless of insurance status.
Fickes accepts private insurance and has cash payment options. He isn’t yet set up to accept Oregon Health Plan patients.
People with OHP have a variety of ways to access mental health care in the community, including through providers such as ColumbiaCare and Options for Southern Oregon. In 2019, Options opened a new three-story mental health center complete with an on-site pharmacy.
People who have private insurance, not OHP, are often the ones who struggle the most finding accessible mental health care in the community, Fickes said.
“We need to provide mental health care for everyone, not just the poorest or the richest,” he said. “We need to help people in between.”
The medical system has moved to have general practitioners provide more mental health care, such as treatment for depression and anxiety. But not all practitioners feel comfortable managing psychiatric medications, Fickes said.
If a patient comes to see him, Fickes does a thorough initial evaluation, diagnoses the issue, talks about treatment options and works with the patient to make a treatment decision. Some patients continue to see him, while others return to their primary care providers for ongoing care.
In an era of COVID-19, Fickes is doing in-person appointments. Both he and the patient wear masks, and he’s carrying out extra sanitizing measures at the clinic. He hopes to eventually add telehealth options.
COVID-19 and fires that recently swept Jackson County have worsened mental health issues for many people, he noted.
“Often the people having mental health issues with COVID and the fires were already struggling with anxiety or depression or past trauma. This is the straw that broke the camel’s back,” he said.
The added problems from COVID and the fires have prompted some people to seek care for the first time for underlying mental health issues, he said.
Fickes said he wants the new clinic to not only offer quick appointments, but to provide follow-up care that helps people shift how they view the issues they face.
“It’s not a quick fix. It’s a place where people can grow and really improve their quality of life,” he said.
Reach Mail Tribune reporter Vickie Aldous at firstname.lastname@example.org. Follow her on Twitter @VickieAldous.