Working with Crisis

Karen Kurrle’s office walls are lined with colorful thank you cards and a basket of therapeutic toys.  Each comes with a story.  Her photo is framed on the wall, with a paper crown glued to her head, surrounded by loving messages from her screeners. A watercolor thank you card from a seven-year old who had lost a parent.

Kurrle has worked for Washington County Mental Health since 1997, as a Children’s Access Clinician, a Program Coordinator, the Clinical Director for Emergency Services, and currently as the Intensive Care Services Director.

“Every day is new and different,” she says. “There’s always ways to do it better, so I always feel like I am growing and learning.”

Kurrle supervises a team of screeners who identify cases of “emergent and urgent distress.”

Patients with an emergent distress could be suicidal, homicidal, dealing with self-harm, or battling various types of depression.  These patients are seen as at risk of acting on their distress and are seen by screeners at the emergency room or police station at any hour.

A patient with an urgent distress is likely to have a lot stressors, struggling, but isn’t as likely to take action, causing physical harm to themselves or others.  

For all patients, Kurrle’s team tries to stabilize some of those stressors and provide coping strategies.

“Our job is to determine the level of crisis and to try to stabilize the crisis for the person to stay safely in their home or the community,” Kurrle explains: “What’s the follow up plan?”

A telephone line is available to the public for any kind of distress. Screeners are on call 24 hours a day, seven days a week. They also have a mobile team that travels to homes, schools, or places in the community.

The patient being screened either goes home, stays home with follow-up services and support, or gets admitted to a hospital.

This job comes with a lot of long work hours, even after she goes home for the night. Kurrle keeps her phone with her at all times, as a screener could be calling her about a case. It can be hard to work with cases, especially when tragedy strikes.

“Some of the hardest cases are when we have to respond to scenes where people have died. It’s really hard, especially when kids die. Families are really distressed.”

She describes the Harwood tragedy that happened in the fall as one of the hard ones: “It was hard to see that much despair and sadness and emotional distress that people were feeling about horrible, tragic circumstances. We just try our best to be helpful, listen to people and hear their stories.”

Though Karen spends every day working to help people get better, she doesn’t usually get to see how her work ultimately affected her patients.

“A lot of times in my job, I don’t get to see what the follow up is or how people do after our services,” she said.

“You don’t always know you’re making a difference; you hope.”

However, other times she does get to see the difference she makes. Kurrle tells a story of running into a young man who she had helped to battle mental health issues seven years earlier. She learned that he had a job, a home, a college degree, and a safe life.

“He showed me in his wallet that he still had my card with my phone number,” she says. “He told me that I was one of the very first people to show him respect and to listen to him from his point of view.”