HOLYOKE, Mass. –The registered nurses represented by the Massachusetts Nurses Association at Providence Behavioral Health Hospital will fight back against cuts to essential child and elder psychiatric services recently announced by hospital owner Trinity Health. The patient care and staff reductions are contrary to Trinity’s stated mission to “stand with and serve those who are poor, especially those most vulnerable.”
“By cutting dedicated child psychiatric services and reducing the quality of elder services, Trinity Health is failing our patients, our community and its own mission,” said Marilyn Hernandez, a Providence RN who works in the child and adolescent unit. “We provide high-quality and increasingly rare psychiatric services for young children at Providence Hospital. Trinity wants to mix children as young as five with adolescents and teenagers, putting their safety and treatment at risk.”
Patient Care Reductions
From what nurses know right now, in addition to RN and non-RN staff cuts, Trinity has said it will close its dedicated child unit and merge services for children as young as five, six and seven years old with services for adolescent and teenage patients, many of whom are being treated at Providence for violence and/or sexual problems. Trinity also plans to increase the number of elder patients psych nurses care for at one time from six to eight, threatening the care quality and safety of another vulnerable population.
Existing Lack of Child Psychiatric Care
The cuts to patient care staff that will reduce care for children at Providence Hospital come as psychiatric services for children are already extremely difficult to find in Massachusetts. Below are independent sources documenting this lack of access:
- The Massachusetts Department of Mental Health details the long wait times for mental health treatment for children, many of whom wait days in emergency departments for inpatient care. Children wait 4 or more days for inpatient mental health care 3 times as often as adults: http://www.mass.gov/eohhs/docs/dmh/publications/acute-inpatient-services-special-populations.pdf
- Harvard University researchers in 2015 found that there are an estimated 101 “stuck kids” waiting in emergency departments for mental health care in Massachusetts: https://www.hks.harvard.edu/sites/default/files/degree%20programs/MPP/files/15%203%20MPP_PAE_Emily%20Hartmann%20Katherine%20Schiavoni_StuckKids.pdf
- The Children’s Mental Health Campaign, a non-profit coalition of families, advocates, health care providers, educators, and consumers from across Massachusetts, says, “While children sit in the ED or medical units awaiting placements, they are not receiving the treatment they were assessed to require. Boarding creates a multitude of stressors for children, families, health care providers, and hospitals across the Commonwealth.” https://childrensmentalhealthcampaign.org/access-services/psychiatric-boarding-project
- A MassLive.com article describes the mother of a 6-year-old in Berkshire County struggling to find timely mental health services for her son and details statewide data showing psychiatric patients face long waits for treatment: https://articles.masslive.com/politics/index.ssf/2017/12/massachusetts_children_with_me.amp
Providence nurses met on Monday to discuss Trinity’s announcement and will continue to discuss ways to push back against cuts to their most vulnerable patients. The announced cuts affect patients near and far. Providence Hospital, with one of the only inpatient child psychiatric units in the region, serves young children and their families from across the Commonwealth.
In a November 2015 article in the Springfield Republican, Christopher Dadlez, then president and chief executive of Trinity Health-New England, said several things to the newspaper that are in sharp contrast to the announcement by Trinity last week:
“Our concerns include health equity, taking care of every person who is in need.”
"We are a faith-based organization that is in the health care business specifically to focus on community patients. They are the center of our universe. When you talk about ministry it is really to minister to our community to the patients that we serve, to the public that we serve, that is the genesis of it.”
Dadlez also told the newspaper that the creation of Trinity Health-New England should ensure the "viability" of its entities in terms of employment.
Providence Behavioral Health Hospital is the premiere private behavioral health facility in Western Massachusetts, serving all ages with inpatient and outpatient services. The 104-bed hospital is the largest provider of behavioral health services in the region. The hospital’s services include acute substance abuse and opioid treatment, along with inpatient adult, adolescent and child psychiatric services.
The current iteration of Trinity Health began in 2013 when the former Trinity Health and Catholic Health East merged. Trinity operates 94 hospitals and 121 continuing care facilities in 22 states. Trinity has a workforce of 131,000, annual operating revenues of $17.6 billion, and assets of $23.4 billion, according to Trinity.
Trinity executives did not tell MNA nurses about their planned patient care reductions and staff cuts during several months of negotiations that recently concluded. Providence nurses on June 29 voted to ratify a tentative agreement that was reached between the elected nurses on the MNA Bargaining Committee and hospital management on June 15. Negotiations began in October 2017 and included 14 bargaining sessions. This was the first round of MNA contract negotiations with Trinity.