Meru Health Inc – 
Action Plan for Declining Mental Health:

The Meru Health Program is a treatment for the relief of depression, burnout, and anxiety, designed to help you feel better and stay that way. However, it can sometimes happen that when you begin to address and explore what’s wrong, you might feel worse before you feel better. It is also possible that events may occur in your life during that might worsen your mood or mental state.

This document outlines the steps to take in the event your symptoms of depression or anxiety get worse while you’re in the program. The Meru Health Program is digital and it does not include face-to-face therapy. For this reason, it is important that you know where to seek medical attention, whether from a therapist or a physician. It is also vital that you know how to determine whether to schedule a face-to-face appointment and then go directly to urgent care or the nearest emergency room. So let’s review the steps we recommend:

Step 1: If at any time you notice your mood or mental state worsening, find it increasingly difficult to engage with life, or have trouble completing the activities in the Ascend program, we would like you to inform your Meru therapist. S/he is available during regular business hours M-F to help guide you in what to do, which might include making some modifications to the program, having more frequent contact with the therapist, or possibly taking one of the next steps. Please be aware that your Meru therapist may take up to 24 hours to respond.

Step 2: Typical symptoms of depression may include thoughts and feelings of emptiness and hopelessness; as if nothing in life is worth living for. If you begin to feel much worse, for example, if you’re having a severe panic attack or having thoughts of harming yourself; or if it’s after business hours and your Meru therapist is not available; we want you to get support. This is not the time to try to "tough it out" alone! If you have a personal therapist or a primary care physician, please contact them right away.

If you are not able to connect with them, then please call the National Suicide Prevention Hotline. There are trained professionals and paraprofessionals who are available 24/7 to talk with you about whatever is causing distress, not just suicidal thoughts. And please inform your Meru therapist if you take any of these steps, so that s/he can follow up with additional support as needed the next business day.

National Suicide Prevention Hotline number: 1-800-273-8255

Step 3: When depression is more severe, some people’s thoughts could turn to suicide planning or a concrete plan to end one’s life. If you feel that you are in immediate danger of being harmed, harming yourself, or harming someone else, the best thing to do is call 911 or go to the nearest Emergency Room right away. Other symptoms that indicate a need for immediate medical attention include increased use of substances, insomnia or decreased need for sleep, hallucinations, or any sudden changes in your behavior or personality. If you experience any of these symptoms, please don’t let embarrassment about being in this predicament get in the way of getting the help you need. The most important thing is for you to be safe. We would also like you to inform your Meru therapist of this as soon as you are out of danger, whether that is while you are at the hospital, or immediately upon your safe return home.