Psychiatric services needed
AS I SEE IT
By Guy Beales
In a letter to the Department of Public Health, dated Sept. 29, UMass Memorial-Health Alliance announced plans to close its 15-bed inpatient psychiatric unit and partial hospitalization services at its Burbank campus in Fitchburg by Dec. 31.
If and when those services end, Leominster and Fitchburg (with a combined population of roughly 80,000) will have no local inpatient and partial hospitalization services. Patients who have regularly used Burbank will experience significant disruption in the continuity of their care. This was brought home to me through the experience of a resident of Leominster who had been a patient at Burbank on several occasions and was dismayed at the prospect of Burbank’s closing; to be hospitalized elsewhere will be a significant additional hardship on her and her family, especially since transportation is never easy or convenient. A patient’s recovery depends, in part, on support from family and friends; the greater the distance from home and neighborhood, the more isolated the patient will be.
Given the prevalence of mental disorders among the adult population, there is need for more rather than fewer adult inpatient facilities. According to the National Institute of Mental Health, about 6 percent (or 1 in 17) of Americans 18 and over suffer from a serious mental illness,such as schizophrenia, schizoaffective disorder, bipolar disorder, major depressive disorder, obsessive-compulsive disorder or a panic disorder.
Right now, in Massachusetts there is a critical and growing shortage of mental health treatment beds, particularly for those with serious mental illness. According to Massachusetts Attorney General Martha Coakley, “The need for inpatient psychiatric and detoxification hospital beds is critical. ... Any further reduction in these services would have a significant negative impact on the ability of the Commonwealth to provide for mental health services.”
HealthAlliance claims patients can be cared for at area hospitals such as Heywood, Marlboro, Emerson, UMass Memorial, and St. Vincent. We simply do not believe these other hospitals, which are already overburdened with patients, can absorb the patient load that HealthAlliance is abandoning.
Heywood Hospital’s president, Daniel P. Moen, has expressed an interest in “expanding the adult mental health unit” at Heywood “to meet the needs of our region.”
It is much to Mr. Moen’s credit that he recognizes the region’s needs, but this is at best a preliminary indication of interest. If Heywood Hospital is to move forward, there are architectural, regulatory and cost considerations to be addressed, and that will take time. In the meantime, the closing of Burbank’s adult mental health unit will leave a significant gap. Local needs will not be met when the Burbank unit closes.
Community HealthLink has expanded its emergency mental health services in Leominster to provide overnight stabilization for eight patients at a time. While most welcome, it remains to be seen whether this expansion will actually reduce “the demand for inpatient psychiatric care in the region,” as CHL’s president, Deborah Ekstrom, suggests. It is crucial that CHL’s services be used in an appropriate manner. They cannot be substituted for secure inpatient beds.
In a recent case, a young man was taken to the HealthAlliance emergency department for a mental health evaluation and spent five days on a couch. For a time, it was thought that he would go to Burbank, but Burbank would not take him. He was then placed in one of the CHL beds. Within an hour he ran away, and the police were called to find him. He was finally placed at Arbour Hospital in Jamaica Plain, 46 miles away. Clearly there is a demand for behavioral health services, but the type of services must be appropriate to a patient’s needs.
From my perspective, we need not fewer but rather more inpatient beds in this region. I urge the Department of Public Health to block HealthAlliance Hospital’s plans to close its mental health services at Burbank, and I urge HealthAlliance CEO Patrick Muldoon and the board of trustees of HealthAlliance Hospital to support those services that are so vitally needed and appropriate for our area.
With the courage and vision to invest in our future, HealthAlliance Hospital and its Burbank campus can be a model for essential community-based services.
Guy Beales is president of the National Alliance on Mental Illness of North Central Massachusetts.