Trinity Health seeks to close 74 psychiatric beds in Holyoke during an ongoing mental health crisis and global pandemic
HOLYOKE, Mass. – During a remote public hearing on Thursday, April 30, a coalition of registered nurses with the Massachusetts Nurses Association, along with patients, families, advocates and other healthcare unions will urge the Department of Public Health to deem essential and halt the closure of Trinity Health-owned 74 child and adult psychiatric beds at Providence Behavioral Health Hospital and a methadone clinic in Springfield that serves approximately 600 patients.
DPH Hearing Info
Timing: Thursday, April 30, 6 p.m. to 9 p.m.
How to Join: Members of the public and other interested parties may join the hearing by phone using the following information: Phone Number: 888-390-5007, Passcode: 2972720
Written Comments: May be submitted to the Department of Public Health, Division of Health Care Facility Licensure and Certification, Attn: Closure Coordinator, 67 Forest Street, Marlborough, MA 01752 or by email to HFLLicenseAction@MassMail.State.MA.US.
Process: Will begin with an introduction to the process by DPH, and then a brief opening statement from the hospital. Following comments by elected officials, DPH will take comments from callers who wish to speak, using the operator to do so. As with other hearings, DPH will ask callers to limit their remarks to three minutes or less so that they can hear from as many people as possible that evening.
The National Alliance on Mental Illness of Massachusetts, a non-profit grassroots organization founded in 1982, issued this statement about the proposed closure: “NAMI Mass opposes the closing of the beds and services Providence Hospital provides at a time when we see those with acute behavioral health conditions being boarded in hospital emergency departments for several hours to several days waiting for bed to open. And this is even worse for children and adolescents, where there is a severe shortage of services in Massachusetts for these, our most vulnerable family members.”
“These proposed closures would devastate an already strained mental health system,” said Cindy Chaplin, RN at Providence and Co-Chair of the MNA Bargaining Committee. “Right now, we need to maximize capacity in emergency departments and other hospitals units, not decrease services. When everyone else in Massachusetts agrees we should be making it easier for patients to get high-quality mental healthcare, Trinity Health is going in the opposite direction.”
Michelle Reardon, Vice President of UAW Local 2322 and a recovery specialist at Providence Hospital, said, “The decision by Trinity Health to close Providence Hospital’s psychiatric units in the middle of a public health emergency is heartless and irresponsible. Our members are concerned about our patients being stranded in emergency departments or in the community, where they are in danger of catching and spreading COVID-19. Trinity’s license comes with a duty to serve the community, not just its bottom line.”
Mental health is public health and the closure of these services would have a devastating impact on our communities. The lack of quality inpatient mental health services and the impact of that shortage on patients, their families and communities has been widely documented. The child psychiatric beds in particular are extremely essential. The closest inpatient child mental health services to Providence Hospital are more than an hour away in Worcester.
Trinity’s plan would also put additional strain on a system facing a public health crisis in COVID-19. As guidance from DPH has stated, “the surge in volume of patients with possible exposure to or symptoms of COVID-19 illness” could “overwhelm the capacity of emergency departments” (Circular Letter DHCQ 02-03-701). Patients should not have to choose between seeking mental healthcare in an emergency department full of potential COVID-19 patients and not receiving care at all.
The way Trinity has responded to COVID-19 has exacerbated the risk associated with closing these beds. Trinity has not provided proper personal protective equipment (PPE) to staff, has not appropriately isolated COVID-19 positive patients and suspected COVID-19 patients, and has cancelled or laid off staff rather than provide fair redeployment and paid time off protocols. These failures mean that patients receiving inpatient care at Providence could re-enter the community as a result of the closure and spread the virus.
The coalition is also asking Trinity to stop its own plan to close these essential services. Trinity’s purported reason for closing is that it cannot find psychiatrists. Our understanding is that Trinity had planned to close the beds and psychiatrists learned of this decision and found other patient care opportunities. We know of qualified psychiatrists in the area who were never asked by Trinity to staff the beds at Providence, despite Trinity’s claim that it could not find them.
In 2017, Trinity closed 12 of 24 beds in the child and adolescent psychiatric unit at Providence Hospital for renovations. Trinity has since refused to re-open the beds and instead cut staff who care for children. They did not officially close these beds. They are currently licensed and among those proposed for closure on June 30. Trinity is claiming its census is low on the 74 beds it wants to close, except it already unofficially closed 12 of those beds. Whatever census numbers it provides are artificially low.
Trinity does not appear unable to keep the beds open for financial reasons. Operating 92 hospitals and 106 continuing care facilities in 22 states, Trinity has annual operating revenues of $19.3 billion, and assets of $27 billion, according to Trinity’s own public statements.
The federal government and Massachusetts have also committed to assisting hospitals as they face the COVID-19 pandemic. Gov. Charlie Baker announced a plan on April 7 to send an additional $800 million to healthcare providers. Asked about the furloughs of nurses at St. Vincent Hospital during a press conference April 16, Gov. Baker said the state has provided almost $1 billion to the health care industry to ensure financial stability. Congress has also approved $100 billion in funding for hospitals in response to the pandemic.
Massachusetts Mental Health Crisis
- The Massachusetts Society for the Prevention of Cruelty to Children has documented this problem at https://www.mspcc.org/boarding-crisis.
- The Boston Globe has reported that “Some patients with mental illness, particularly children, are spending days stuck in tiny windowless rooms in hospital emergency departments waiting for treatment…” https://www.bostonglobe.com/metro/2018/07/17/long-waits-persist-for-children-mental-health-crises/iD2trxkXIlYtqmsuoqTWII/story.html
- The National Council on Aging reports that “Two-thirds of older adults with mental health problems do not receive the treatment they need. Current preventative services for this population are extremely limited.” https://www.ncoa.org/news/resources-for-reporters/get-the-facts/healthy-aging-facts/#intraPageNav2
- The DMH 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
- A 2013 New England Journal of Medicine article noted the “silver tsunami” of aging adults who will have mental health problems but a lack of treatment availability: https://www.nejm.org/doi/full/10.1056/NEJMp1211456#t=article
- 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
Founded in 1903, the Massachusetts Nurses Association is the largest union of registered nurses in the Commonwealth of Massachusetts. Its 23,000 members advance the nursing profession by fostering high standards of nursing practice, promoting the economic and general welfare of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Legislature and regulatory agencies on health care issues affecting nurses and the public.