Intensive Outpatient Program: Mental Healthcare

A Mother's Perseverance: Navigating a Daughter's Mental Health Journey

Teens are moody. Thanks to the hot mess of hormones that floods their bodies during puberty, teens can fluctuate between sadness and elation at any given moment. Parents intellectually know that ups and downs are to be expected, but it is hard to know when moodiness crosses the line between normal and abnormal. Cultural views of mental illness can compound such confusion. This is the situation that Marisol Valadez found herself in when her oldest child, Bianca, became a teenager.

“My problems began when I was 12. I was in a very dark space and was very angry with my family all the time. I started self-harming,” says Bianca.

“It was hard,” Marisol explains. “I was a young mom; she was my oldest. I didn’t really understand because I had never dealt with anything like anxiety and depression before. And we’re Hispanic. I feel like, in our culture, [mental health] is a tricky subject. If you’re sad, you get up and get over it, just keep going. It’s part of life.”

When Bianca was 14, a miraculous coincidence brought Marisol to the Behavioral Health Center (BHC) at Eastern Idaho Regional Medical Center (EIRMC) when she was hired to work on the BHC’s housekeeping staff. Encountering mental health patients and their caregivers opened Marisol’s eyes to the reality of mental illness.

“My mom became my number one supporter,” enthused Bianca. “She educated herself on mental health, depression, and anxiety. I tried a therapist first. When that didn’t help, mom talked to co-workers at the BHC and found a psychiatrist for me.”

The psychiatrist diagnosed Bianca with generalized anxiety disorder and major depressive disorder.  Bianca began the process of testing various medications but she did not really believe they were needed. When she moved away to go college, Bianca quit taking the meds.

“That’s when my issues got really bad. I didn’t go to class; I quit my job; I didn’t want to be with my family. It got to the point where I felt like everyone would be better off if I wasn’t here. I saw the therapist again, and they wanted me to go to the hospital for treatment. Instead, I went home.”

Marisol clearly recalls the frightening phone call she received from Bianca’s therapist:

“She told me, ‘Your daughter has a plan. She’s figured out how she’s going to do it.’ The therapist wanted her to go to the hospital right away, but Bianca insisted on driving herself home. 

 “I told my boss that I needed to take a week off to help my daughter… I remember driving home in tears, thinking I was going to lose her. At home, I told her we’d figure it out together, and I wasn’t going to leave her side. That whole week, I slept on a mattress on the floor of her room. It was tough to see her like that. I told my husband, ‘This isn’t my daughter—it’s like her soul isn’t there.’”

With her mom’s support, Bianca restarted therapy and started taking college classes online with accommodations. Marisol managed Bianca’s medications, making sure that she took them every day. Slowly, Bianca started getting better. But then, a tragic set back occurred. Bianca was sexually assaulted, and she quickly spiraled downward.

At work, Marisol confided her situation to a coworker, Brandi Daw.

“I told her, ‘If I don’t get help, I’m going to lose my daughter. I don’t know what else to do. Therapy isn’t enough. Her depression is getting worse. That’s when Brandi told me about the IOP.”

The Intensive Outpatient Program (IOP) is run through the BHC at EIRMC. IOP is a “middle ground” for people needing a higher level of treatment than weekly therapy can provide but for whom psychiatric hospitalization is not indicated or has already occurred.  It combines multiple modes of treatment such as individual therapy, group therapy, and medication management to ensure patients’ success.

While Bianca credits the IOP for saving her life, she and her mother acknowledge that it was a bit of a challenge to access insurance coverage for treatment. Once again, Brandi Daw stepped in.  As the Director of Physician and Provider Relations for Behavioral Health Services, Brandi had unique insight, and was able to guide Marisol through the approval process. 

“The Intensive Outpatient Program (IOP) is in-network with EIRMC’s mental health insurance plan with United Healthcare (Optum) and most major insurance providers, including commercial, Idaho Medicaid, and Medicare,” Brandi explains. “The IOP team helps potential patients navigate the insurance process.”

First, the patient provides the IOP team with insurance information, which includes the information on both the back and front of a current insurance card. Then, a dedicated IOP team member contacts the insurance company to get details needed to access mental health care available at EIRMC.

“IOP staff verifies a patient’s coverage with their insurance carrier prior to them starting the program. The IOP team also recommends that patients contact their insurance provider directly to verify coverage.”  

For more specific eligibility and benefits questions, call the Customer Service number on the back of your Member ID card. If you do not have an ID card, Brandi recommends contacting your HR or benefits department.

Once the IOP team verifies the benefits available, they contact the insurance provider and obtain prior authorization to begin treatment. 

It was well worth the effort for Marisol to go through this process. The IOP proved transformative for Bianca.

“The therapists, the nurses, they all actually listened to me. They acknowledged what I was saying and going through. They were honest and told me it would take time to get better. I went there three or four days a week for several hours. If I didn’t show up, they called right away to find out why. I knew that they cared about me, as an individual. This wasn’t just a job for them; they saw me as a person.

“I learned mindfulness. Cognitive behavioral therapy gave me resources I didn’t know about. One therapist especially, Eric, helped me so much. He gave me new ways to cope. I’ve never felt like that in therapy – like he really cared, like he was family. Everyone was so patient with me. They didn’t even push me to talk about the assault. They let me decide what I needed to discuss.”

It has been a year since Bianca left the IOP, and she is steadily moving onward and upward. In all aspects of her life, Bianca’s future looks bright.

“My relationship with my family is much better. I’ve worked through the assault. I have a job. I’ve also changed my major to social work and psychology so that I can focus on mental health, to help people who are struggling like me... I’m passionate about this.”

Marisol still works at the BHC. She hopes that Bianca’s story will reach other parents who are desperate to help their troubled teens.

“I would tell them to keep going, keep looking. When one door closes, somewhere a window opens. Your kid’s life is worth everything, so don’t give up…. If our story reaches just one person, then it’s worth it.”

Click here to learn more about the Behavioral Health Center and the Intensive Outpatient Program at EIRMC.