Frontline Caregivers Say State’s Mental Health System is Already in Shambles
Shortage of Beds & Lack of Funding Jeopardizes Patient Safety
Proposed Closing Will Be Devastating for the State’s Most Vulnerable Residents
TAUNTON, MA – The Massachusetts Department of Mental Health (DMH) informed members of the Massachusetts Nurses Association/National Nurses United (MNA/NNU) of their plan to close Taunton State Hospital, one of only six state operated mental health facilities in the state to care for people suffering from acute and chronic mental illness.
The shocking announcement came at a meeting this morning held with senior DMH staff, and will result in the loss of more than 169 beds to a mental health system in Massachusetts that already is overloaded, and unable to provide appropriate mental health care as it is currently constituted.
“This is a cold hearted and dangerous decision that will have devastating consequences for the mentally ill in our state,” said Karen Coughlin, RN, a nurse at Taunton State Hospital and vice president of the MNA/NNU. “We have no mental health care safety net in Massachusetts. There are not, and have not been, enough beds or services in the system for years. This decision will only exacerbate a long standing crisis. People will continue to go without care, crime will increase, homelessness will increase, more people will end up in the corrections system and many more will commit suicide. This closure along with other cuts to programs and services represents the state’s continued abandonment of the mentally ill in our society.”
In announcing their decision, the state claims it will move 120 of the 169 beds to the new Worcester State Hospital, with the other 45 beds going to Tewksbury State Hospital. However, the decision to build the new Worcester State Hospital was made to compensate for the closure of Westborough State Hospital a number of years ago.
“Their plan makes no sense,” Coughlin said. “Our system has been operating well over full capacity for years. We can’t provide the care people need even with our facility open. The other issue is geography. We are now forcing patients and families to travel to Worcester, Tewksbury or out to Western Mass for their mental health care. It’s a travesty.”
To understand the role and value of the state’s inpatient facilities, one needs to have a clear picture of the clients they serve. “At our inpatient facilities, particularly at my facility, Taunton State Hospital, we take care of a significant number of forensic patients, which means they come to us from corrections facilities or the court system, with varying levels of criminal involvement and some with histories of violent behaviors. At all of our facilities we have many frail, elderly mentally ill patients who can’t be cared for in nursing homes. A large percentage of our patients have a dual diagnosis of mental illness and substance abuse which complicates their placement in community settings. We have a number of women suffering from serious trauma who are self abusive and suicidal and need intensive mental health monitoring and care. These are patients that often have nowhere else to go in the system,” Coughlin explained.
In fact, there is a shortage of psychiatric beds throughout the entire health care system in our state, including the public and private sector. Right now, we have psychiatric patients clogging our emergency rooms across the state, some waiting for 72 hours or longer for a psychiatric bed placement. According to a recent statement by Massachusetts Attorney General, Martha Coakley, in a report concerning the disposition of psychiatric beds following sale of hospitals to Cerberus/Steward Health Care, “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.”
A 2009 report by the DMH showed that the census at the facilities like Taunton State were running at an average census of 97 percent, and as of today’s announcement, the census at Taunton State was over capacity. The same DMH document, pointed to “an already significant reduction to DMH community services with the elimination of day and employment services and a reduced case management work force.” It further stated that, “more than 200 of the 788 adult patients in DMH continuing care facilities are ready for discharge but appropriate community services are not available.”
The MNA/NNU, which represents nearly 100 RNs and health professionals who work at Taunton State Hospital, and more than 1,800 staff who work throughout the state system, is committed to working with policy makers and elected officials to ensure that Massachusetts, which used to be a leader in the provision of mental health care, maintains its commitment to the most vulnerable residents of the Commonwealth.
“This has gone beyond an issue of funding and finances,” Coughlin concluded. “This is a moral and ethical issue of human rights and common decency.”