Uninsured Salt Lake County residents who need therapy or psychiatric drugs have few places to turn — with primary mental health safety nets now essentially closed to new patients.

The waiting list is weeks out for an appointment for new patients at Valley Mental Health's two clinics for the uninsured. And Valley won't schedule new patients for July at the Resource and Resiliency Clinics because its future in providing those services — outpatient medication management and therapy — is uncertain.

New patients who don't want to wait are heading to the Whole Health Clinic, but it recently closed its doors to new patients because of the increased demand by Valley patients and others. The Utah Chapter of the National Alliance on Mental Health is taking calls from patients wondering where to go — and NAMI doesn't know where to send them.

"We are really at a loss as to how to help people," said Sherri Wittwer, NAMI's consultant. "There's nothing except the ER, and they don't belong there."

Valley has a contract to provide services to the uninsured for Salt Lake County through June 30. On July 1, OptumHealth will take over the administration of mental health services in the county and contract with providers, including Valley.

While Valley expects to sign a contract with Optum to care for uninsured patients, nothing has been signed, according to Valley CEO Debra Falvo. "We don't even know what we'll have for our [uninsured] clinic going forward," she said.

Rick Elorreaga, OptumHealth's Salt Lake County executive, said the company intends to contract with Valley to provide care for patients who do not qualify for Medicaid.

Valley will continue to see existing, uninsured patients into the summer, said Jona Nusink-Curry, who oversees the uninsured clinics. "It would be irresponsible for us to cease treatment just because we're unsure of funding," she said.

She said the "two-week-plus" wait for new patients who want to be seen through June is partly due to staff turnover. Valley is laying off 100 employees through the end of June, saying the cuts were necessary to compete for Optum contracts and to pay for transition costs, according to Falvo. In addition, more employees have voluntarily quit during the uncertainty.

Unless they have a critical need, uninsured patient visits are being pushed back so that Valley providers can see Medicaid patients first. "Our Medicaid population is our priority" under Valley's Medicaid contract, said Nusink-Curry. "The folks who have no insurance ... have to take a secondary role."

At the same time, more uninsured patients are seeking care. In 2010, Valley's two clinics served 670 people. It has seen 340, or about half of last year's total, in the first four months of this year.

The demand is so great, Valley is running out of money it has for the uninsured. It receives $3.8 million, in state and mostly county funds, to care for residents who do not qualify for Medicaid. The funding supports programs that include Valley outpatient clinics, jail diversion programs and crisis response — but it's now gone, according to Tim Whalen, the county's director of mental health.

Also gone is the $1.2 million the county required Valley to spend from its fund balance, he said, noting that Valley now is spending more than was required.

"They've been great partners and stepped up and provided more services than dollars available," he said. "Our county has always had a lot of additional dollars for those services. It's just not enough."

Valley is referring new patients who need an appointment now to other providers, including the Whole Health Clinic, even as Valley's nurse who works at Whole Health has had to close her services to new patients.

The Whole Health Clinic is at a Utah Department of Health medical clinic at 168 N. 1950 West. While the clinic has been able to see mental health-only patients for $5 a visit in the past, it now will only see patients who are also physical health patients, said clinic office manager Michelle Grossman.

She said the mental health demand only recently dropped from 15 calls a day to about five.

"Usually Valley is where I [would] refer them," she said, adding that she doesn't anymore. "They'll usually say, 'Oh, that's where I'm coming from.' "

Susan Miller is Valley's advanced practice registered nurse who works at the Whole Health Clinic. She has a waiting list for psychiatric evaluations for new patients into July.

Some of those new patients are coming from other mental health providers, including the Family Counseling Center. The money for its pharmaceutical assistance program ran out early, and since United Way cut its funding for the program, the funds won't be replaced. The center transferred 20 uninsured patients who need medication management to Whole Health.

The center has up to a four-month waiting list for uninsured patients who need counseling.

"With the changes in the economy, the demand has increased," said Kate DellaPiana, the center's executive director. "You see substance abuse increase, you see [more] marital conflict and family violence."

Other providers that Valley said it is sending new patients to can't take them, including Silverado Counseling, which doesn't see uninsured patients, and the Maliheh Free Clinic, where patients would have to wait for five months to become a physical health patient before they could see a counselor. Maliheh doesn't offer medication management.

"I'm sad to know Valley Mental Health is referring to us because we send a lot of people over there," said Jeanie Ashby, Maliheh's executive director. Patients are "probably getting the runaround."

hmay@sltrib.com