Holding The Line Between Crisis And Care | Jessi Beyer, MHP

The quietest lifesaving moments often happen between a slammed door and a deep breath. We sit down with crisis mental health clinician and SWAT negotiator Jessi Beyer to unpack what it really takes to bring a volatile scene down, earn trust in minutes, and move someone from danger toward safety. Jessie works nights alongside law enforcement on 911 calls involving suicidal ideation, psychosis, and severe substance use, and she opens up about the tools that work when nothing else seems to.

You’ll hear how a winding path from vet school to EMT to graduate studies in trauma and terrorism shaped a clinician who knows her lane and thrives in it. Jessi breaks down tips for de‑escalation you can use anywhere: matching tone without escalating, reflecting the exact pain under the behavior, and delivering the one line that can drop someone from a ten to a six. We talk about realistic definitions of success in crisis care, why “alive tonight” is often the right metric, and how clean handoffs and community resources reduce reliance on emergency rooms and revolving-door hospitalizations.

We also confront a blind spot: up to 75% of people who die by suicide see a primary care clinician within a year. Jessi offers practical, time‑smart suicide screening questions any clinician can use, along with ways to sit in discomfort and listen without rushing to fix. And for trauma survivors who don’t thrive with talk therapy, we explore evidence‑supported alternatives like dance/movement therapy, canine- and equine-assisted work, and ecotherapy, drawing from Jessi's book on natural therapies.

If you’re a clinician, student, or curious listener, this conversation delivers actionable skills, candid stories, and a humane framework for care under pressure. Subscribe, share with a colleague, and leave a review to tell us which de‑escalation tip you’ll try this week.

Connect with Jessi Beyer at: 

Website: https://jessibeyerinternational.com/

Instagram: @itsjessibeyer

Transcript

Welcome And Mission Of The Show

Ashley Love 0:00

Hello, and welcome to Shadow Me Next, a podcast where I take you into and behind the scenes of the medical world to provide you with a deeper understanding of the human side of medicine. I'm Ashley, a physician assistant, medical editor, clinical preceptor, and the creator of Shadow Me Next. It is my pleasure to introduce you to incredible members of the healthcare field and uncover their unique stories, the joys and challenges they face, and what drives them in their careers. It's access you want and stories you need. Whether you're a pre-health student or simply curious about the healthcare field, I invite you to join me as we take a conversational and personal look into the lives and minds of leaders in medicine. I don't want you to miss a single one of these conversations. So make sure that you subscribe to this podcast, which will automatically notify you when new episodes are dropped. And follow us on Instagram and Facebook at Shadow Me Next, where we will review highlights from this conversation and where I'll give you sneak previews of our upcoming guests. Today's guest does work that most people never see and very few people could actually do. Jessie Bayer is a crisis mental health clinician who responds alongside law enforcement to 911 calls involving suicidal ideation, psychosis, and severe substance use. She's also a trained negotiator on her SWAT team. When situations are volatile, emotional, and dangerous, Jessie is the mental health professional in the room, helping bring things down, keep people alive, and move them toward safety. Her path here is just as powerful. EMT training, a background in psychology, graduate work and trauma, crisis intervention, military psychology, and terrorism studies. Every piece of her story has shaped the way she shows up in moments that matter most. In this episode, we talk about de-escalation, emotional intelligence, knowing your role in medicine, and what it really means to be a steady presence in chaos. Please keep in mind that the content of this podcast is intended for informational and entertainment purposes only and should not be considered as professional medical advice. The views and opinions expressed in this podcast are those of the host and guests and do not necessarily reflect the official policy or position of any other agency, organization, employer, or company. This is Shadow Me Next with Jesse Beyer. Jesse, thank you so much for joining us today on Shadow Me Next. I am thrilled to hear what you have to say and the incredible story you have to bring to us today.

Jessi Beyer 2:40

Oh, well, thank you for having me. I'm I'm super excited to talk about it and figure out how we ended up in this world that I currently work in. So I'm super happy to be here.

Ashley Love 2:48

Which is a really incredible world and one that is um I, you know, I say this to like our helicopter nurses and our critical care physicians, that their their life is high stress, high reward, but really nothing holds a light to what your high stress, high reward situation is, which of course we're gonna break down. But Jesse, we're gonna start at the beginning here because you gave me a little teaser and I just cannot wait to talk about it. Tell them how you ended up in this field of medicine, is what we're gonna call it, in this field of medicine that you are experiencing right now.

From Vet School To EMT To Psych

Jessi Beyer 3:24

Yeah, so this is definitely kind of a weird story. So going back even a little bit before the teaser that I gave you, when I was in high school, um, my boyfriend at the time attempted suicide. And that was just a really, really difficult night for me. I had been his big support system. I was the one who called 911 to prevent that attempt from being completed. And in kind of the aftermath of that, of course, law enforcement shows up, he gets taken to the hospital. Um, there was a social worker that showed up with the cops as well. And she talked to me for a little bit, you know, hey, are you okay? She gave me her card. You know, if you need anything, you can reach out. And I was like, that's cool. And then promptly put her business card in my bathroom drawer and like didn't think about it. So there was this seed that was planted in my mind that I really didn't think I could do much with. Um, and it just kind of sat there for a while. And then when I decided I, you know, wanted to go to college and was figuring out what I wanted to do, my freshman year of college, I actually went to veterinary school at the University of Edinburgh in Scotland. For context, I grew up in Oregon. So that was quite a departure from the world that I was used to. And I got there and I was like, well, this is not what I thought it was gonna be. It was um a bit of a moment of breaking the rose-colored glasses of what I thought veterinary medicine was. And what really crystallized that for me was recognizing that the care stops when the money runs out or the animal is no longer of value to the humans, not when the job is actually done. And for my personality, I'm very much a like complete it at all costs type of person. And so that really, it was just like this whole moral thing of I don't think I can do this for the rest of my life. I don't even think I can do this for the rest of the five-year degree program. So I was like, I need to get out. I need something where um I can just I it's it's me and the patient, and I can complete this job. And so I went to Canada and I got my EMT license. And I was like, I'm gonna go into emergency medicine because it's just me and the patient and the back of an ambulance, and my job is to keep them alive. There's no politics involved. Anyone who works as an EMT knows that there are tons of politics in EMS, but my like naive self thought that that's what I was gonna do. Um, and I loved it. Like that EMT course that I took was one of my favorite educational experiences that I've ever had in my life. I just absolutely loved it. So I was like, okay, I'm gonna stay in Canada, I'm gonna get my paramedics license, I'm just gonna work in emergency medicine, it's gonna be great. And uh my parents were like, yeah, but babe, you need a college degree. Like you, you have to go to college. And I was like, but do I? And they're like, yes. And so I was like, fine. So I went back to the States um and I finished my degree in psychology at the University of Minnesota. It was a bit of a protest degree, I will say. I was kind of like, I don't really want to be here. I don't know what I want to do, but psych is somewhat interesting to me. And so what the heck, I'll go ahead and do it. And my uh one of my elective classes, my senior year, maybe my junior year, one of my last two years, um, was on nature-based therapies. And that really turned the tide for me because that piqued this interest for me. Um, back after my high school boyfriend had attempted suicide, I went to one day of therapy um after that. And it was just, it was traditional talk therapy, like nothing crazy. I hated it. I was so uncomfortable. I literally ran out of the building, like full on running out of the building. Um, and I never went back. And I thought that that was my option, was like talk therapy or bust, essentially, as I was trying to heal from this. And so learning that there were these other modalities that are out there, there's other ways to heal from traumatic events. That really got me back interested in the world of psychology. So ended up finishing that degree. My capstone was on different integrative trauma therapies, movement-based, nature-based, animal-assisted, all these different things. Um, and then I just started speaking and talking. And I did a lot of work in education, peer support education, um, integrative therapy education for a number of years until I landed in the space that I landed in now, um, which, as we talked about in the intro, I do crisis mental health work alongside law enforcement. I'm a negotiator on our SWAT team. Um, and another little breadcrumb for this is after I graduated college, undergrad, uh, before I went to grad school, I um I did a ride along with our local deputy and his mental health professional partner. And we went to a call where it was a domestic violence situation and they ended up having a negotiator come out. And I remember sitting in the back of this patrol car and I'm like, hey, that's kind of cool. Like, could I ever do that? And they're like, no, you have to be a cop to be a negotiator. And I was like, oh, okay. And again, filed it in the bathroom drawer kind of thing. Um, and ended up being a negotiator, not being a cop. So it's interesting how this world comes together. Um, and I guess I in that process, I skipped over grad school, which is pretty important. Um, for me, I took a couple of years between undergrad and grad school. Um, I really am glad that I did that. I was told, you know, if you stop school, you're never gonna go back. And I have learned through my own experience and through the experience of a lot of my friends that that is not the case. Um, so I took a couple of years and then I went to grad school for critical psychology and human services. Um, and I focused a lot of my education on trauma and crisis intervention. So I got to design some of my own courses. For example, I took a course on PTSD in military and first responder populations. I took a course entirely on sexual assault, which sounds like very heavy and traumatic, but was just wildly interesting to delve into all the different elements of that. Um, so really amazing educational experience. Um took another couple of years off and then went back and got a second master's in military psychology with a focus in terrorism. Um, and all of these like weird educational things that I've done over my life have set me up really well for the work that I do now and given me a very unique perspective to bring to the table. Um, so yeah, in like a very long nutshell, that is my my journey to where I am today.

Ashley Love 9:11

It's such a cool journey, and I love it because um, even just speaking with you briefly for a couple of minutes, all of a sudden, all of these different elements, all of these different pieces of your life have really beautifully just combined into this perfect role for you, really. And you mentioned a couple of things, and I'm so glad that you brought them up. First of all, um, you just lit up when you talked about your time as an EMT in Canada. And and I love to hear that because I think so often people think of their role as an EMT um as being perhaps a stepping stone to something else. Like so, for example, I'm a PA, I'm a physician assistant, and we um a lot of students will get their patient contact hours as EMTs. And speaking with so many of my colleagues, they say, Ashley, I almost did not go to PA school after this because I enjoyed being an EMT so much. Um, so I'm so glad you brought that up. It's such a fantastic career, and I would imagine really, really, really sets you up for the work that you do right now, communicating um with some of the different people, law enforcement agencies, fire departments, SWAT. Um, it's a whole different lingo, right? And you speak it, I would imagine, largely because of some of the stuff you encountered as an EMT.

What A Night Shift Looks Like

Jessi Beyer 10:19

Yeah, absolutely. It's it's a wonderful, wonderful career. Um, and through my work as an EMT, I got to do a lot of like sports events and youth sports events, which being a child athlete myself, I was like, so cool. I'm back in basketball land. Um, so that was really fun. And then I also did work as an EMT with search and rescue. So now we're talking like backcountry, austere, like things are breaking and we have to fix it with a stick kind of thing. Um, hopefully that's why I'm there as I bring more stuff. But it's that type of environment. Um, and just all these amazing experiences. And so for any of your listeners, any of your audience that is considering emergency medicine as a path, I will say now I love working with EMTs in the role that I have now because they're often the ones that law enforcement and I show up first. We do safety checks, immediate de-escalation, whatever that is. And then if the person needs to get transported to the hospital, I'm not driving them. The cop isn't driving them. It's an EMT crew that comes and takes them. So being able to hand off to them, not only speak their language to have that professional relationship, but also that empathetic touch that that EMT brings because they have that ride into the hospital to just chit-chat with that person. Like there's no medical intervention necessarily that needs to be done. But if you're thinking about a career in emergency medicine, it's not just I'm treating heart attacks and I'm treating broken bones. It's I'm talking to a kid that wants to kill themselves, or I'm running around with a search and rescue dog trying to find someone lost in the middle of the woods. Like there's so many different elements to that career field. Um, and whether it's a stepping stone or a permanent place, like I think it's a wonderful entry into medicine.

Ashley Love 11:52

No, I totally agree. It is a fantastic opportunity to really see humanity, unfortunately, at its most significantly painful moments, which we're gonna talk a lot about here in just a couple of minutes. But before we get too far into that, let's talk about your role because I think I think it is just so interesting. So you really you sit at this crossroads, right, of medicine, of mental health, and of public safety, which I think is is such a cool and unique place for you to be. Tell us what you do when you go on scene with law enforcement or fire rescue, when when you show up in the morning, what does your job look like?

De‑Escalation Tools That Work

Jessi Beyer 12:34

Yeah. Well, I will specify that I don't show up in the morning, I show up at night. Um, so I work, I work swing shift, um, which is two to midnight. And uh the reason that I highlight that is for a number of different reasons. But one is that's when a lot of crises happen. And so if you're working in any sort of first response or emergency health care, might not be a nine to five. So just kind of prepare yourself for that. Um, and the other thing is that oftentimes I'm the only mental health resource that's available at that time. Private practice is closed, substance use disorder treatment centers are closed. It's kind of just me. And so I frame that before going into like what I actually do. So I respond alongside mostly law enforcement, sometimes EMS, sometimes both, um, to 911 calls that have some sort of behavioral health element. And the three most common ones for me are suicidal ideation, psychosis, and substance use challenges, andor a conglomeration of multiple of those. When I show up on scene, my role is twofold. One is the immediate de-escalation. So we've had folks that have knives, we have folks that are screaming bloody murder, we have folks running down the middle of the highway at two in the morning. How do we take this from level 10 to like maybe a level three or four where we can actually have a conversation about next steps? Part two of my role is what are those next steps? I will always tell people I would be a terrible private practice therapist. Um, God bless people that do that, but that is not me. I love the immediate work and then passing them off to someone else for longer-term care. And so part of my role is that pass-off, right? What resources are available? Um, where can we put you or take you or connect you with so that you don't continue having these crises? How can we reduce the alliance with the reliance on the 911 system on hospitalization, look at community-based care? And that really spans everything from securing bus tickets for people, like bus passes, um, housing, treatment for mental health, for physical health, for substance use disorders. Um, we have a specific resource in our county for um temporary fostering of pets while people go to detox. And so it's this interesting world of knowing all of these different resources, knowing who has a wait list, who doesn't, how do you access it, what are the access criteria and admission criteria, and kind of crafting this plan with the client of, okay, great, we fixed the immediate crisis. We're no longer screaming. What do we do now? Where do we take you next? And so that is just as much a part of my job as that immediate de-escalation risk assessment type stuff that I do.

Ashley Love 15:05

That is so cool. Thank you for breaking that down so well for us. I think there's a couple of ways I want to go with this. Number one, immediate de-escalation. I'm like, I'm having flashbacks to moments of like the last three days with my children, really, because there's so many times I've said, is this a crisis? Are we in crisis right now? And they've said no. I'm like, well, they're rescreen. Let's please calm down. But um, the immediate de-escalation, I would love to hear some of the tools that you use for that, right? And and this is number one, this is for your role because obviously you use this every day. I in dermatology, I am not chasing people down a highway, usually. However, there are definitely moments when I realize I've walked into a situation that's very, very hot, very, very tense for whatever reason. Now it's not as typically as dangerous as your situations, but knowing some of these tools for de-escalation, especially in healthcare, is super important to get to the point quickly with some of these patients. Say, what are um, tell us a few, if you can, some of these tools that you use.

Jessi Beyer 16:02

Absolutely. I'll ground this in a scenario that happened a couple months ago, perhaps. I took a client to the hospital. She had been endorsing suicidal ideation. She wasn't willing to do a safety plan and stay at home. So we're like, okay, we're going to the hospital. Um, and this particular client's story, she had a very difficult sexual relationship with her husband, a lot of coercion, a lot of obligatory interactions there, just very not healthy, lots of trauma background going on there. And so we're in this hospital room, and the nurse comes in and is like, okay, I need to draw your blood. And she's like, No, you don't. Why do you need to draw my blood right now? And they started kind of going back and forth at that. And the nurse just got stuck in this cycle of, well, I understand what you're going through. And the client was like, No, you don't. You have no idea what I'm going through. No, trust me, I do. I've seen a lot of people in your position, yeah, but you don't understand what I'm going through and just button heads. And I was standing in the room and I could just feel the tension in everyone just start going up. Um, and I think that that happens a lot because as healthcare workers, especially in the emergency department, you kind of have seen it all. Like you've probably seen people in very similar situations to this woman's situation. And so in your mind, you're like, no, I I get it. Like I've seen people in your situation before, but in that client's mind, they're like, no, you haven't. You don't know my story, you don't know my situation, you don't know what's going on with me. And so I say all of that to highlight the point that the biggest thing that you can do in terms of de-escalation is set aside yourself, set aside what you've seen, your experience, your perception of this client, and sit with that person in their moment of pain. So that can kind of take one of two ways. If you have a very sad, depressed, crying that type of person, it's going to be calmer. You know, this is more of my client voice when I'm talking with someone who's in that type of emotional state and it's very validating and labeling emotions. And yeah, I mean, it sounds like you're really, really going through a hard divorce right now. Like whatever that is, right? It's getting on their level. It's that calm type of reflecting the emotions that they're sharing with you. If you have someone who's coming in and they're screaming and they're mad and they're this, I'm gonna reflect that a little bit. It's gonna be more, yeah, dude. I get it. Like you were out there, you were just minding your own business, and then all of a sudden you're hog tied and brought to the hospital. I'm doing the same skill of reflecting the emotion of I don't want to be here. I brought, I was brought here against my will. I'm frustrated, I'm mad, I'm whatever. But I'm matching that a little bit and then slowly working my way back down. Sometimes it works if you can come in with a really, really escalated person and you are like barely, barely speaking, because then they're like, I can't hear you, and then they bring themselves down immediately as well. But sitting with them in that space sometimes means you're mad with them. And so if you can bring yourself to that level, have that conversation. Usually what happens with folks that are really, really escalated is if you can get one really good reflection in there. So one sentence of, yeah, it sounds like you were minding your own business and then all of a sudden all these cops showed up, or yeah, it sounds like you were having a really difficult fight with your wife, and then she threw in this really hard insult or whatever. I don't know, whatever it is. If you can get one really good one of those in there, they will go from a 10 to a six almost instantaneously. Um, and one story for this, just to put a more a little bit more color to it, we were out on a SWAT call, I think it was like three in the morning. Um, and this kid, he was about 10 years old. He had just watched his father shoot his grandfather. Um, and he got drug out of bed by law enforcement to get him out of the house to get him to safety. Um, and so I'm talking with him and he's pacing, he's talking a million miles an hour. He's talking about like three levels of volume louder than he needs to be, and just going on about how disappointed he is in his dad and how his dad hasn't been there for birthdays and hasn't done this and hasn't done that and all these different things. And he just was like at his dad. And I said to him, I was like, Hey, it sounds like you've been looking for more from your dad for a really long time. And he was like, Yeah, and is full possible. Changed. He sat down on the curb. He lowered his volume. He slowed his speech. And so just that one line, I was even sitting there being like, that worked better than I thought it was going to work. Like I shocked myself with how that line worked. It's not always that easy. But my point is, if you can get that one, one good reflection, one moment of rapport, that is often enough to take a really escalated person down a few notches and then as a provider, help ensure your safety in that situation as well.

Defining Success In Crisis Work

Ashley Love 20:27

Absolutely. It's reading between the lines and it's so much easier said than done. I like to call it the hidden gem in clinic. And sometimes it's something that they say offhanded as an aside that if you can recognize it, if you can pick it up, um, and just try to scooch it in as well. I mean, you can't attack it. You cannot attack these things. But if you just kind of ease into it, like you mentioned, I heard you say X, Y, and Z. And oh, by the way, this one too, they feel heard, they feel understood. And like you said, it can absolutely de-escalate a situation. Um, or even and even if they are already calm and collected, but maybe withdrawn and not sharing, sometimes it can help open them up as well. So, oh, thank you so much for sharing those. Those are really, really good examples. I love it. And something that before I move on that I want to um that I want to touch on real quick, you mentioned that most of the calls that you are that you're that you go to um late at night are suicidal, suicidal ideation, psychosis, and substance use. But then you just mentioned a 10-year-old. Do you see adults and children then? Are you involved in both?

Jessi Beyer 21:36

Yes. So the youngest client that I've ever had was six, and the oldest was late 80s, early 90s, I think, somewhere in that about to go into the nursing home type of age range. Um, so yeah, I I respond to everything. Um, anything that touches the 911 system. Um, we have a lot of parents that call in on their kids because the the we have it's funny, I'm gonna say this, and for me, this is like, oh, this is a Tuesday, and it's gonna sound wild to anyone who is not a part of my world. Um, we have a kid who his parents call 911 on him a lot because he continually tries to kill his dad with a knife. Um, and so we're figuring out how to navigate that situation. So we have that side of things. Um, we have a lot of folks that call in on loved ones who have endorsed suicidal radiation in some capacity. So husband sent me a text saying goodbye for real, or daughter posted a bottle of pills on Snapchat. We get a lot of those. Um, and then we get a lot of concerned citizen calls for the person who's running down the highway at two in the morning or different things like that. So it is a very, very wide group of people that I work with.

Ashley Love 22:39

Which I think is really interesting. And because there's certain elements of medicine, as you can imagine, that are very, very focused when it comes to who you see and what you do. Um, and this career sounds like it's very broad, which I think to some people, uh, to a lot of people would be quite interesting. Um, you mentioned a couple of things that I think are really hot in media right now, and that is recognizing some of these signs that we're seeing of suicidal ideation, primarily self-harm, things like that, which this is something that you see all the time, all day, every day. And um, of course, we want we want people to report this. Any little thing, it is absolutely worth checking up on. Um, let's keep each other safe, the whole, the whole nine yards. What does success for you look like in crisis negotiation, even when sometimes the outcomes maybe aren't perfect?

Know Your Role In Medicine

Speaker 1 23:31

That is an amazing question. Like, wow, first of all, awesome. I love that question. For me, um the first thing that comes to mind, and this is maybe a bit um simplistic, but it's keeping them alive. And the reason that I I say that, and everyone's like, oh, it's healthcare, of course. Our goal is to keep them alive, but there's a lot of commentary in the media right now about well, law enforcement just arrests people that have mental health challenges and we just take them to jail, and there's all these things that are you know wrong with that. And I agree, jail is not the ideal situation for folks, right? That's not the ideal healing scenario. But when intensive outpatient has wait lists a mile long, when inpatient is full and there's no beds available, I can't get someone well if they are not alive. And so if that means that they're going to the hospital or they're going to jail, that's a win. I would say that my, you know, ideal situation is this um, you know, terribly depressed teenager that I speak with, and then we make this amazing safety plan, and then they're de-escalated and they get to stay at home and they go to school the next day, and you know, they email me six months later and they tell me that they're doing amazingly. I've had those. I had this one kiddo that I took her to the hospital dozens of times, sponsoring these force on her dozens of times to get her to the hospital. Um, just chronic, chronic suicidal ideation. And I was given her parents like resources last grade and center. I could not figure out what to do with this kiddo. And then she just dropped off the face of the earth for like six months. And I was talking with my law enforcement partners, and they're like, Yeah, we haven't heard from her either. And I was like, Well, she's either better or she's dead, and I don't know which. Um, and I I heard from my deputy a couple months after that. He's like, Hey, I ran into her in a coffee shop. And I was like, And he's like, Yeah, she's doing amazing. Like she went to inpatient treatment down in California for a couple months. She got a job, she is training her service dog. Like, she's doing so well. And she told me to tell you thank you. And this client emails me every couple months. I get a little email on my inbox that's like update. And then she tells me some new things that are going on in her life. So those are like amazing wins. And I love those and I cherish those. And when I don't have good calls, those are the ones that I go back to of like, no, you're still good at your job. It's okay, you still help people. Um, but at the end of the day, it is keeping them alive enough to get them to a longer-term resource, is really what success looks like in my role in some of these complex situations.

Ashley Love 26:01

Thank you for that answer. It is, like you said, it seems like a very simplistic idea. But you're right. And a lot of people might not view that as an ideal success. Um, but I really the the picture that you just painted of I can't help somebody if they're dead. And if they're in jail, most likely they're still alive. It reminds me a lot of the situations when people go to the emergency room, which I've I'm sure as an EMT, you saw this. People have these chronic lifelong conditions. And for whatever reason, that day they've chosen today is the day that I'm gonna go to the ER and get answers. That's not what the ER is for. You're gonna show up to the ER, they're going to see, are you going to die in a couple of minutes? No, we're getting you out of the ER, you know, that's kind of similar. So it it just it really highlights the fact that as clinicians and as as people looking to healthcare as a career, you have to know your role in medicine. And we each play a role in medicine, right? You've mentioned before, which I I do want to come back to as well, that you appreciate the fact that you see people in crisis in mental health crises, but you are not managing their care long term. There are other clinicians who I'm sure would not know what to do in crises and serious men, they don't know how to chase somebody down the interstate, right? But they appreciate that long-term care relationship. This is the same thing, you know, we have to manage our expectations as clinicians and what type of medicine we're going to enter. And as patients, we have to manage their expectations of what they're going to get in that area of medicine, right? It's why our ERs are so busy right now. As, like I said, as an EMT. I'm like preaching to the choir right now.

Why Embed Mental Health With Police

Jessi Beyer 27:44

Yeah, yeah. And frankly, I've been in the ER more as a mental health professional than I was as an EMT because we get a lot of folks that end up there as well. Um, but your point is so valid, and that's something that I think I I kind of had to learn the hard way when I got into this field because I definitely came into it a little bit arrogant. I was like, I'm the mental health professional. Um, I know what to do. I'm gonna get these people connected with this resource and that resource, and they're gonna be fine, and then I'm never gonna see them again. Obviously, it doesn't happen that way. And so I had to recognize that my role is this 10 to 60 minutes that I have with you. And if I can be a little bright spot in your chaos darkness of a life, I have done my job. And whatever happens once I take them to the hospital or once I refer them to detox or once I find them housing, like that's out of my control what they do in that situation as well as what that provider does in that situation. But I can be really, really, really good at my 10 to 60 minutes. And that's really what I've focused on. And I would encourage anyone who's going into healthcare, exactly like you were saying, know your lane, be really, really, really good at your lane, and let everything else go, or you're gonna drive yourself absolutely crazy.

Quality Question

Ashley Love 28:55

One of the things I care most about with Shadow Me Next is helping students prepare for their own pre-health interviews. So in every episode, we include a quality question, not to test you, but to help you practice reflecting, communicating, and showing who you are. Jesse Bayer reminds us that some of the most important work in medicine happens in 10 to 60 minutes. Not in long-term plans, not in perfect outcomes, not in tidy stories, in the moment, in chaos, in space between crisis and safety. If you're a pre-health student, ask yourself, can I stay calm when others can't? Can I listen without fixing? Can I sit in discomfort? Can I be present without control? This is the side of medicine that shadowing shows us. The real side. Keep in mind that there's more interview preps, such as mock interviews and personal statement review, over on shadowmext.com. There you'll find amazing resources to help you as you prepare to answer your own quality questions. I love that. That is just like, oh, can we like paint that in glowing gold letters and just plaster it everywhere? It would be incredible. Um, okay, let's shift just a little bit because I would like to talk a little bit more about mental health and the grand scheme of things in medicine as a whole. Um, in your opinion, how has embedding the mental health clinicians that you see that you work with that you are in the first responder systems? So this is, you know, coming in with police officers, mainly police officers, firefighters as well, changed outcomes. How have you seen it improve the lives of these clients that you're seeing?

Jessi Beyer 30:40

It's been revolutionary. Um, and I want to start this conversation by saying that I love my law enforcement partners. Like, I think the absolute world of them. I am so lucky to work with them. Um, I really just every day I walk into work and I'm like, I love you guys. And like, shut up, Jesse. I was like, I know, but I love you guys. So we we have an amazing, amazing relationship. Um, but this integration of mental health into law enforcement is beneficial for a bunch of different ways and reasons. First and foremost, no one, very few people at least, go into law enforcement wanting to deal with people in mental health crisis. They go in for the burglaries and the fights and the shootings and all these different things. Um, generalization, right? Of course, there's there's different folks in different places, but they don't go into it to talk to the suicidal person for three hours. And so for me to come in and say, hey, you don't want to do that? I want to do that. Perfect, right? Let's do that trade-off there. Um, it allows me to take a little bit more time, have a little bit more understanding. Um, and then also bringing that additional knowledge. Cops, especially in the US, are tasked with so many things that is not actually part of their job description. They are the dumpsters of humanity. And I mean that in the best possible way in that when people don't know what to do with something, they have law enforcement handle it. And so they have such a wide breadth of responsibility and things that they do and are involved in and are, you know, responsible for that are not really law enforcement and they don't have the adequate training for that. I mean, yes, a lot of departments go through maybe 40 hours of mental health-related training. That's amazing. I love it. I have two graduate degrees in the space. Like there's just a different level of education there. Just like I have no idea what I'm doing when it comes to um writing a warrant or arresting someone. Like, I don't know, different lanes, right? And so me being able to bring that additional expertise, communicate with them of like, hey, this person isn't trying to be combative right now. They're actually experiencing chart of dyskinesia and blah, blah, blah, blah, blah. And like explain what's going on to them can change the outcomes of that. Um, and then additionally, having the knowledge of those different resources, like they will just call me and be like, I don't know what to do with this person. What do I do with them? And I was like, okay, great. Well, you can send them here and here's a referral and here's a phone number for this. Taking that responsibility of having those additional resources upon myself means that a law enforcement doesn't have to. But then also the clients have kind of this one-stop shop of where they can get referrals to different places. The other thing that I'll say is that a lot of times the addition of a mental health professional or the addition of a crisis negotiator on a SWAT call reduces the use of force. Um, and I have looked for studies to back up the numbers on this and they don't exist, but this is just me speaking experientially. There have been a lot of calls where if I was not there and I was not able to talk the person into the ambulance or one of my negotiators was not able to talk the person out of the house, there would have been force used, there would have been gas bombs thrown in the house, there would have been, you know, all these different things that maybe would have escalated that situation. But because we come with a different perspective and a different personality and a different base of knowledge, those outcomes are potentially different. Not all the time, doesn't always work. Um, but in terms of negotiations, at least the the statistic out there is like if we can get on the phone with them, about 80% of the time we're able to negotiate them out instead of having to use force. So there's that element to it as well. Um, very rambling answer, but those are some of the benefits of um implementing mental health.

Ashley Love 34:01

Not rambling at all. No, that was that was fantastic. Great examples as well. And I would imagine, you know, we we were TV is not real life, and we watch all the SWAT shows and we see them busting into houses and they're like so excited about it and they love it so much. And I would imagine there are some people that do love that. However, I would also imagine that most of them are thrilled to have you so that they don't have to do that, so that they don't have to traumatize this person where they're not out to traumatize people, right?

What Clinicians Miss About Suicide Risk

Jessi Beyer 34:29

No, absolutely not. Just a note on TV before I actually respond to that. Um, I love the show Criminal Minds. I watched Criminal Minds like religiously when I was a kid. Um, it makes me so angry because everything that they do negotiation-wise in that show is like wildly inaccurate. And I'm like, no, no, we would never do that. That doesn't work that way. So, yes, not real life. Um, in terms of your actual point here, it's very, very true. There are 100% people that are like, hell yeah, I want to go boot down the door. We have moments of hell yeah, I'd like to go boot down the door as a mental health professional. Like, we all have those moments of, yeah, we want to get in there, we want to go after it. Um, but there's also times where they don't. Um, and for example, we had a client one time, 400-pound trained MMA fighter, flurriedly psychotic. Um, and there was a warrant out for his arrest. And so I call him, and the first thing he says is, like, what do you want? If any cops come to my door, I'm gonna fight him. And he had a history of fighting law enforcement. And I ended up talking him out of the house. It was peaceful, he got arrested, it was all good. But I was talking to my sergeant afterwards, who's on the SWAT team, and he was like, I am so glad you were here because I did not want to get in that fight. And I knew that if we got into that fight, he was going to the hospital and we were probably going to the hospital too. And so there very much is that perspective of, yes, okay, harm reduction is amazing, but I am literally preventing sometimes my deputies and my clients from getting punched in the face. Um, and that feels really good, like to be able to have that influence and just keep the physical safety of people safe as well.

Ashley Love 35:56

Which is incredible too, because this is a very much of a side note, but your hobbies are incredibly physical and very, very tough. So, you know, I I could probably bet on you against a 400-pound MMA fighter. I feel like you could probably take them, even if you wanted to. But again, that that is an aside. We do not have to go there. But definitely check out Jessie's Instagram and some of the really, really cool things that she's doing there. Let's talk directly to our clinicians now and our future clinicians. What do you wish that every future clinician or current clinician understood about suicide risk that we are missing?

Jessi Beyer 36:29

Yes. This is where I get on my soapbox. In specifically primary care, um, about 75% of people that die by suicide have seen their primary care physician in the year before they died. And in most primary care settings, there is no screening. There's no discussion. At most on an intake checklist, there is a have you experienced thoughts of harming yourself or others? Yes or no. And then that's kind of the end of the discussion. Primary care physicians, clinicians in general, and I'm I'm almost intentionally excluding emergency clinicians here because they get this all the time, like that's a pretty common part of their life. But like everyone else, you are in a prime situation to screen for patients that are experiencing suicidal ideation, to do risk assessments, to do referrals, and to literally save these people's lives just by asking a few questions. And that is what I get incredibly passionate about when talking to healthcare teams because they're like, oh, you know, I'm I'm a dentist, right? Or I'm primary care or I'm an OBGYN, like whatever. I'm not dealing with people in crisis. And what I tell them is that yes, you are. You just don't know that your people are in crisis. Or they're presenting with some sort of somatic symptom that is, you know, a chronic stomach ache or chronic headache or um their acne has flared up out of the blue or whatever that is. Putting those pieces together and understanding not to get like too woo with it, but like the mind-body connection and the fact that what's going on upstairs is going to be reflected in the rest of the body, recognizing that, understanding that, and taking the five minutes to sit down with your patient and say, Hey, what are you doing? Like just tell me about your life. I I hear that you're here for a stomachache, but what else is going on for you? No one does that. No one does that. And so taking that time, they might say, Oh, yeah, you know, it's okay. You know, you know, work's been, you know, up and down lately, but all in all things are good. Okay, you know, up and down. What do you mean by that? What's been going on there? Oh, well, you know, um, actually, I I just got fired recently. Okay, now we're getting somewhere, right? Now we're digging in and we're having this conversation and you're learning things about your patients that you wouldn't if you just had that intake checkbox, do you want to die or not, type of thing. So you are you as a clinician, right? You are at this critical juncture where you can intervene in your patients' lives in ways that you probably don't think you can, and that statistically you absolutely need to.

Ashley Love 38:46

You're right. And it's it does take a minute. And I think that as clinicians, we hear that and we think, well, I only have 20 minutes times 30 appointments throughout the day. But every each of those 30 appointments, you're not going to be having this conversation, right? I mean, this is something that maybe you pick up um a handful of times and you address it, and most people will just blow you off, or there's actually nothing wrong. But that one person that there is, and that one person that you really get to tap into. Um, there's this happened to me in clinic, and I am in dermatology. So very much in that whole realm of things, we had a patient come in. She was very hesitant to disrobe, to take her clothes off, which is kind of part of der if we, if you're there for us to look at your skin, we have to be able to see your skin. Um, extremely hesitant, the point where my medical assistant came, got me, and said, Hey, listen, I don't think we're gonna be able to do this, et cetera. I walked in just so that she could meet me, even if we weren't doing a skin check that day. Recognized something, I don't know, a little that spidey sense, right? Um, and we dove into it a little bit. She's a sexual assault survivor, literally within the last number of weeks, but she didn't want to cancel the appointment because she's trying to normalize her life, which I was so proud of her for doing, et cetera. Um We didn't take her clothes off at that appointment. We sat there and I had a 20-minute appointment slot. So we talked for 20 minutes, right? And then I said, Hey, when you're ready, I would love for you to come back in. How can we make this comfortable for you? How can we make this appropriate for you so that I can check the areas of your skin that you want me to check? Um, and we did, and you know what? Every single time she comes in, she brings a gift, which is so sweet. She does not have to do that. But I'm just so grateful because um, you know, first of all, she has gorgeous skin, so she doesn't need to be there to see me, but I'd like to think that that positive experience is hopefully going to fuel other positive experiences for her in healthcare to where she can go back to see her GYN and she can get those routine exams and she can see her male PCP. Um, so it, like you said, you know, sometimes it just takes that one brief, brief moment. And uh it's it's one of my absolute most favorite stories in healthcare. And it started off with something so miserably painfully sad and a terrible conversation that I had to have with the patient. But um, what a great relationship it is now, you know, it's really, really cool.

Jessi Beyer 40:58

That's amazing. And I know that you are not the one being interviewed, Ashley, but like that story just oh my gosh. I mean, it warms my heart so much. It's obviously terrible and traumatic and it makes me sad at the same time. But knowing that there are providers like you out there that took that time, that saw that warning sign and did something with it, like just gives me so much hope. Um, and I'm not overstating this, like I'm saying this as someone who sees crisis every single day, sees sexual assault survivors every single day. Um, you may have saved her life. At the very least, you changed the trajectory of her life dramatically. Um and her life could have taken a very, very different turn if she didn't have those 20 minutes with you. And so for everyone who's listening, who's considering going into healthcare, who's already in healthcare, obviously you want to help people, you want to make a difference in people's lives. But maybe you're in a field where you're like, I don't save lives, you know, like I help people, but I'm not saving lives in this profession. You are, and you can. You just have to take those few minutes and have that conversation and invest that time in someone who, yeah, came for her skin, but she needed an ear and a shoulder and someone to be there with her. And you gave her that. And that's amazing. And it makes me very happy.

A Dermatology Story That Saved Trust

Ashley Love 42:07

I like yeah, I never even thought of it that way, Jesse. But you're you're right. I mean, you're right. Obviously, this is this is what you do. You're absolutely right. And um, you know, to me it was just 20 minutes, but who knows what it was, uh, what it was for her. Oh my gosh. Before we really wrap up, if this conversation is just really influencing you and you you want to know more, I would highly recommend you pick up Jesse's book. It's called How to Heal: A Practical Guide to Nine Natural Therapies You Can Use to Release Your Trauma. And this is amazing because it sounds like it was written for trauma survivors, for people who have experienced trauma. But I will tell you, as a clinician, this book is invaluable because I'm going to be, I have, as I've mentioned, talked to these people. And having some of these tools that you've talked about, things like eye movement desensitization, um, dance movement therapy, canine assisted therapy, which of course, knowing your background and as a maybe veterinary medicine practitioner at one point, this makes a lot of sense. Equine, of course, as well. Um, uh, ecotherapy and nature-based therapies. These things are amazing. And just would give people so much hope to, you know, like I said, to come to your dermatologist and have your dermatologist talking about different therapies that they've learned from you. Um and uh just tell us a little bit about this book, who it was written for, and uh, and what you hope to do with it.

Jessi Beyer 43:26

Yeah, so this book was a passion project for me, and it really was born out of my own experience, like I mentioned, thinking that I either could go to talk therapy or I had nothing, and I had to kind of figure it out by myself. Um, and I realized that that wasn't the case. There are other modalities out there. And so this is really written for the person who has tried the traditional trauma therapies and they haven't worked for them, and I will go into that in just a second. Or for the people who don't want to try, they're uncomfortable with that for some reason. There's some part of their story that doesn't align with that, and they're looking for something else. Um, so these are all wonderfully rich methods of healing from trauma, body-based, movement-based, nature, animals, all these different things, very holistic methods of healing from trauma that are also empirically supported. Because I'm as much of a data nerd as I am like this woo-boo fluffy, hug a dog and feel better type of person. Um, so they're really wonderful modalities there. In terms of kind of traditional trauma treatment, when I reference that, uh, the American Psychological Association recommends a few talk-based therapies and then some medications for trauma treatment. So we're looking at cognitive behavioral therapy, we're looking at exposure therapy. Um, those are kind of the two biggest ones, and then your combination of SSRIs and SNRIs for medication-based trauma treatment. Um, and the APA, the American Psychological Association, likes to kind of tout these as the gold standard and everything else is subpar. And if you really dive into the literature on these different modalities, depending on the study, it's about 50% of people that achieve benefit from those therapies. And then if you get even further into that, you have to determine whether benefit means a clinically or I'm sorry, a statistically significant reduction in clinical symptoms or a reduction in symptoms to a level below the diagnostic criteria. Because some of these studies, to simplify the diagnostics on it, um let's say that you come in with 10 out of 10 on the trauma scale, on the PTSD scale. Um, and then the the baseline for diagnosis is a five. So you have to at least get a five to be diagnosed with PTSD, but this person comes in with a 10. Well, they got down to an eight because of this treatment. Yay, it's a huge success. They still have PTSD. Like they're still incredibly symptomatic from this. And so as you're reading these studies, you really have to get into like what is considered a success? Is it clinical remission or is it a significant reduction in symptomology? Both are good, but it it lands differently depending on what you're looking at there. So my point of that is there's a lot of folks that are helped by these therapies. And I love those therapies for those people. There's also a very large chunk of people that are not. And what happens in this American Psychological Association-based world of treatment that we live in is one of two things. The patient gets blamed. So there's a lot of studies out there that talk about, well, patient noncompliance and patient refusal to engage and all these different things. And my response to that is if your therapy is so traumatic that no one wants to do it, it doesn't work. Like it's not good enough. We need to amend that. Um, so that that is one thing that'll happen is the patient will get blamed, or they will be told there's nothing else. There's nothing else out there for you. You either have to do this or you're on your own. And so my book was really created for that person who's been in that experience to say, hey, it's not your only option. There are other things out there. And it's very much written, human to human. It's not clinical language. It's me just blabbing like I am right now about all these different modalities. Um, so it's very approachable. In a lot of them, I actually went to that therapy. And so I talk about here is my experience, here's what we did, here's what it felt like, here were the revelations that I went through. Um, and getting kind of personal with some of that. So people can maybe experience a session before they actually have to go themselves. Um, and so yeah, I mean, that's that's my goal with it is spread awareness, spread hope, and spread options for people that are looking to heal, but don't feel like the traditionally presented options are gonna work for them.

Healing Beyond Talk Therapy

Ashley Love 47:11

Oh my God. Awareness, hope, and options. Could we want nothing more? It's just a fantastic gift that you have given. The book, again, is called How to Heal: A Practical Guide to Nine Natural Therapies You Can Use to Release Your Trauma. It's available on Amazon. Um, and if you guys have fallen in love with Jessie as much as I have, please check her out on Instagram. It's Jessie Bayer. That's J-E-S-S-I-B-E-Y-E-R. It's Jesse Bayer. Um check her out on LinkedIn, same name. And then, of course, on her website, Jessie Bayer International.com. Jesse, thank you, thank you, thank you for the work that you do. I am so glad to know that there are people like you out there um meeting us in our deepest and darkest moments. And like you said, you are just this small beacon of light. Um, and thanks for joining us on Shadow Me Next and sharing your story today.

Jessi Beyer 48:03

Absolutely. Thank you for having me. And anyone who's listening, if you're curious about this field, it is new-ish. Like it's we're kind of on the forefront of it. So if you have questions, if you're like, I'm curious about it, I want to try it, I want to learn more about it, like shoot me a DM, shoot me an email. I'm happy to just talk about what I do and help you figure out if it's something that you're interested in as well.

Ashley Love 48:22

Incredible. Thank you so much, Jesse. Thank you so very much for listening to this episode of Shadow Me Next. If you liked this episode, or if you think it could be useful for a friend, please subscribe and invite them to join us next Monday. As always, if you have any questions, let me know on Facebook or Instagram. Access you want, stories you need, you're always invited to Shadow Me Next.