THE COUCH
Aaron Burch
Drs. Ora Frankel (left) and Debbie Thomas sit in the lobby of The Couch, the
immediate mental health care facility which the pair opened in early 2014.
The two physicians agree their work has been a labor of love.
O
ra Frankel, MD, designed The Couch, Kentucky’s first
privately owned urgent mental health care facility with
a simple premise in mind: when a person needs mental
health assistance, they need it now.
“Most people don’t come in for a psychiatric wellness check,
they only come when they’re in crisis,” said Dr. Frankel, sitting in
her office near Brownsboro Road. Across a two lane street sits The
Couch, her newly opened labor of love which opened on January
15, 2014 after more than three years of research and preparation.
“I knew the need for an alternative was there. Just in my own
office’s experience, there are a limited number of patients I can
see. If I’ve been seeing a patient every three months but some
crisis happens and they want to come in early, I know how hard
it is for me to get them in,” said Dr. Frankel, who has practiced in
Louisville for 20 years after moving here with her husband in 1994.
“So the idea came to me, ‘If I can’t get my patient in, I’d much
rather they go to an urgent care facility and see someone really
good and qualified then go to the ER,” she said. With this thought,
The Couch began to take shape.
To begin her research, Dr. Frankel asked how possible was it to
find mental health care for patients in a state of emergency. “We
called 42 psychiatrists in the region. Only one was taking patients
earlier than six to eight weeks away,” she said.
Dr. Frankel, masquerading on the phone as a patient in need of
assistance, was told by multiple psychiatric offices to contact the
University of Louisville’s Emergency Psychiatric Services. They
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LOUISVILLE MEDICINE
said, “That’s your only real option.’”
“So I did. I called EPS, got a machine, left a message, nobody
called me back. I kept calling, and eventually they picked up. They
said a doctor could see me today but I would have to wait a while.”
In addition to the University of Louisville, Baptist Hospital
East has a 24-hour psychiatric service in its emergency room.
Dr. Frankel, however, doesn’t believe it matches the possibilities
of an urgent care facility based outside of an ER. “Their facility
is great, but the job of a psych ER is triage: does this person need
in-patient, out-patient or intensive out-patient treatment? If you
need in-patient or intensive out-patient, they can get you going.
But the great majority of people only need out-patient - at which
point they’ll say you need to call and make an appointment with
a psychiatrist - back to square one.”
In Dr. Frankel’s opinion, an ER is among the worst places for the
patient to seek assistance for several reasons, not the least of which
is the cost. “On average, a visit to the ER costs somebody approximately $1,800, whether it’s the patient, the insurance company or
the hospital. The doctors and nur