PROVINCETOWN — The week following Labor Day often feels like a deep and heavy exhalation here, as the community’s collective task of hosting, serving, and entertaining more than 10,000 guests per night eases into the slower and softer rhythms of September.
For many people this year, that seasonal exhalation was more of a pained gasp for breath. The news of the death by suicide of Chuck Giachinta, a well-known server, bartender, and restaurant manager, spread rapidly through town on Tuesday, Sept. 2 as his loved ones posted tributes to him online. (His obituary is on page A16 of this week’s Independent.)
“If you knew our friend Chuck, you knew how incredibly kind he was and incredibly hard-working and dedicated to hospitality,” said select board member Erik Borg at the board’s meeting on Sept. 8. “He was a really beloved member of our community and, from my vantage point, not someone you would expect to be struggling in this way. It’s really shocking.”
The other board members offered condolences as well. Select board chair Dave Abramson said that the coming winter months can be even harder for people who are struggling.
“There is help in this town,” said Abramson, “and hopefully the more we talk about it, the less stigma there is, and more people will be willing to talk about what’s going on and seek help.”
Reaching Out
By coincidence, the town had announced a new online mental health platform on Sept. 2 — a collaboration with seven other Outer and Lower Cape towns — operated by a company called CredibleMind. The platform includes self-assessments for depression, anxiety, and other conditions and a list of 30 organizations that offer various kinds of support.
After receiving word of Giachinta’s death, the town also organized a pair of meetings that it had previously conducted after the death by suicide of bartender Stephanie Leonard last October.
On the morning of Sept. 4, an hour-long “community grief support session” was held at town hall, followed by an hour-long suicide prevention program that about 20 people, including seven or eight town staff members, attended, according to Health Director Lezli Rowell.
Bri Smith, a behavioral health specialist at Outer Cape Health Services, conducted both sessions.
“We wanted to hold space for people who might have been feeling grief-stricken,” said Rowell, because news of a suicide can bring on an especially difficult type of grief. “The first session was intended to be: ‘Let’s talk, or let’s cry, or let’s remember this person, but let’s not be alone with what happened,’ ” she said.
The suicide prevention program is “a nationally known platform and methodology” called QPR, for “question, persuade, and refer,” Rowell said.
The protocol encourages people to respond when friends or loved ones “sound like they might be contemplating harming themselves,” Rowell said. Don’t be afraid to ask probing follow-up questions, she advised. “You then use persuasion, such as, ‘Promise me you won’t do anything until we make some phone calls and get you connected to care,’ ” Rowell said, followed by a concerted effort to arrange for professional help.
The “refer” part of the equation is crucial, said Assistant Town Manager Dan Riviello, who attended the sessions.
“This is not just important for people who are feeling terrible,” Riviello said. “There’s a lot of responsibility on the rest of us to care for the people in our lives, notice if they’re struggling, or ask if there’s something going on, and then refer them to the resources that are available.”
Town Therapist
Riviello also said that he came away from the two sessions feeling overwhelmed by the complex web of mental health resources.
“One of the things I was struck by was the table of pamphlets and brochures — it felt like 30 of them, and it seemed daunting to me, let alone to someone who might be in crisis and faced with how to find all this information,” Riviello said.
The next day he started working on a four-item list for the town’s website, framed in bright yellow rectangles, that would be “simple enough to print on a magnet for a fridge or to keep on your phone” and find in an emergency. The list should go online later this week, Riviello said.
“In an immediate emergency, you call 911 and our first responders will be there in minutes,” Riviello said, describing the first item on the crisis list. “Right after that there’s 988,” the national suicide and crisis hotline, “and then there’s Bay Cove. Their mobile crisis intervention team is available 24/7, and their goal is to get here within an hour.”
Bay Cove has deployed to Provincetown at least once in recent months, Riviello said, to help someone experiencing a crisis.
Finally, the fourth item on the list is contact information for the town’s community resource navigator, who can make referrals to the town’s public health nurse and town therapist — two clinicians that the four Outer Cape towns have shared since February 2024.
Initially funded through a one-time $381,375 grant of county American Rescue Plan Act (ARPA) money, the public health nurse, Kerry Cox, and the mental health and substance abuse counselor, Cassie Baker, are now funded directly by the four towns through a contract with Outer Cape Health Services.
Each town contributed about $60,000 in this fiscal year to support the two clinicians, whose services are free and do not require health insurance.
The public health nurse has been especially valuable in addressing the health needs of homebound people, Rowell said, while the therapist works as a “bridge counselor,” seeing patients for 6 to 10 sessions while trying to organize longer-term mental health support for them.
Accessing Care
Even though the towns pay for the two clinicians, information about them has been relatively scarce on all four town websites. Provincetown’s website has an item about them under “public health programming,” while the health dept. web pages for Truro, Wellfleet, and Eastham do not mention them outside of meeting minutes.
The new CredibleMind website does not list the clinicians as a resource for the Outer Cape towns either — something Riviello and Rowell said they would like to change.
During the first phase of the shared clinicians program, Rowell said, it was town staff at councils on aging, police and fire depts., health depts., recreation programs, and schools that referred patients to the nurse and therapist. “That was the initial rollout when we were ARPA-funded — to let staff be the referring agencies, so to speak,” she said.
The community resource navigators who serve the Outer Cape towns — who also work through contracts with Outer Cape Health Services — have since taken on a greater role in making direct referrals to the nurse and therapist, Rowell said.
That means reaching out to the navigator is now the most effective way to reach the town therapist, Riviello said.
“We want people to know there’s a resource that’s available pretty immediately for someone to get access to mental health care,” Riviello said. “I think people don’t think that’s possible — that if you’re not a patient at Outer Cape Health or you don’t have insurance, that you can’t get care.”
The navigator can be reached at 774-209-3222, at [email protected], or during “office hours” at the Provincetown library from 10 a.m. to 1 p.m. on Thursdays. “Call or email or go into the library on that day, and I think you’ll get connected pretty quickly for at least that first appointment,” Riviello said.
“That’s something we really want to get across — familiarize yourself with how to get help, and then be on the lookout for each other,” Riviello added. “Reach out and refer that friend.”
