Anxiety and depression started for the boy at the tender age of 7 and continued well into adulthood.

Over the years, he attempted suicide by overdose several times, alienated long-time friends and returned to a toxic romantic relationship multiple times. His life was filled with shame, which is not uncommon for people who struggle with behavioral health challenges.

He never knew where to turn.

“I didn’t feel there were people I could reach out to,’’ said the man who preferred not to be identified.

After a lifetime in and out of behavioral health programs, he’s recently turned to a new program that offers online group therapy sessions. Since he works from home and does not own a vehicle, the sessions have been helpful.

“Personally, I like virtual,” he said. “I like being in the comfort of my own home: my safe space. If I want to turn off the camera, I can. I can leave the call if I’m feeling uncomfortable. I have more control than in person, making me feel safer.

“Yes, it’s a lot of self-work. It is a lot of self-care, but you need those tools,” he said.

What is IOP: intensive outpatient group therapy

Mica Stone, a clinical behavioral health therapist with UCHealth’s new virtual Intensive Outpatient Behavioral Health Therapy Program (IOP), has worked in the mental health field for 14 years.

“I want to speak to how powerful group therapy is,” said Stone, who joined UCHealth in May 2021 to help launch the virtual group therapy program in 2022. Its mission is to improve patient access to specialized behavioral health care.

“Being part of a group that understands the challenges, the pain, chaos, and sometimes, even humor, that comes with our life challenges is so beneficial,” Stone said. “To share part of yourself with others – that experience alone is powerful – but then you get feedback from someone that’s not a therapist, someone that is in the trenches with you. There is benefit and transformation that can happen through group work.”

For the Fort Collins man, knowing others are having similar experiences and learning tools to navigate crises has been beneficial and a change.

“You’re expected to share during these groups. I did and do participate, but I don’t always feel comfortable about it. I don’t think others do as well, but I think it is helpful. I’ve always said, ‘You get what you put into it.’’’

Managing mental health challenges takes work, as anyone who has attempted to get help knows. It’s not a one-and-done experience but an ongoing effort.

“With all my therapy, DBT (dialectical behavioral therapy), IOP – all of this training that I’ve done for my mental health, and I do think it’s training – all that stuff is very difficult. It is not easy to do, but you won’t get better if you’re not talking about the things that make you feel a certain way. You have to try.”

After his second suicide attempt about two years ago, he called 911 and was eventually admitted to UCHealth Mountain Crest Behavioral Health Center. He spent about five days in the inpatient program, left and returned to a toxic relationship. His girlfriend assured him everything would be different – everything would be fine. But it wasn’t. A year passed, and his anxiety became overwhelming.

“I was done. This is not how things should be,” he said. “I was panicking and freaking out – and that was the next time (I attempted suicide). Life wasn’t getting better after another three years of these choices we made together.”

He walked to Mountain Crest in the middle of the night. He told caregivers he had taken a stomach full of prescription pills to attempt to dull his pain. He again went through the inpatient program and was then enrolled in UCHeath’s new online intensive outpatient group therapy.

“It is supportive of people needing the care intensively to maintain their lives outside of inpatient care and preventing that need for inpatient care for challenges like suicide and emotional stress,” Stone said.

Online group therapy: UCHealth’s virtual behavioral health intensive outpatient program

While inpatient care is important and intervention for safety, Stone said a lot of work happens outside an inpatient setting, and ongoing therapy increases the likelihood of long-term success.

“This program allows us to offer the best of two worlds. We see them often; they engage with group therapy and see people with similar situations. That’s extremely effective.”

Stone said studies show that online IOPs are just as effective as in-person group therapy because there are not the external challenges that often prevent people from the commitment needed for IOP.

An IOP meets for three hours three times a week. A person may be part of an IOP for five to eight weeks. A “step-down” IOP meets for 1.5 hours a week for four to six weeks. There are generally 10 to 12 people, plus a facilitator, in each group, which is tailored to individual needs.

The groups focus on different challenges. There are online groups for those who have depression and anxiety, for example, and a group for people who have mental health challenges and substance use disorder. There is another for addressing grief and trauma, and a group for adolescents. Stone and her colleagues are continuously monitoring to determine whether individuals are in the right group or may do better in another one.

Breaking down the barriers and challenges to accessing mental health support

“I’m passionate about this model,” Stone said. “With such a lack of access to behavioral health care, we can provide care when people can’t access it in a traditional way. Often people lack transportation or have a disability that limits their mobility. This makes it so much easier, and they also often feel safer to get the care in the privacy of their own home.”

In recent months, the Fort Collins man turned to his training learned in online group therapy sessions after his longtime girlfriend moved out and started dating someone else. When that happened, the man again had thoughts of harming himself.

“But then I could put it (the breakup) into perspective and understand this was for the best and would make things better. I got through it,” he said. “I’ve had thoughts of hurting myself, but I haven’t. I went to my skills. I got myself out of it, and I continue to do so every day because it is a choice to do so every day.’’

He says he has been attending group therapy for 90 minutes every week.

“I’ve been doing well,” he said. “It’s helping. I continue to grow and learn about myself.”

Stone said people can take a few different paths to get into an online IOP. The program accepts referrals from Mountain Crest, UCHealth, and other community providers, including primary care physicians. Individuals also can self-refer by calling the UCHealth care coordination team at 720.520.9048 and expressing interest.

A person then connects with a caregiver who sets up a mental health assessment to ensure the program is a good fit and there are no safety concerns. The assessment helps determine what IOP will be best for the individual. The team also works with insurance companies to receive necessary authorizations.