New Travis mental health center expected to fill gap, save money

July 16--

When Austin Police Sgt. Mike King is called to a mental health crisis, his options are slim: He can take the person to an emergency room or a psychiatric hospital. Each is expensive, and often, less than ideal, he said.

That's about to change.

An $8.9 million gift from the St. David's Foundation will enable law enforcement officers to take Travis County residents in crisis to a short-term psychiatric center opening next summer. The facility in Southeast Austin will be built on land valued at $900,000 to $1.2 million that Central Health will lease to the community's mental health agency for $1 a year.

The Central Health board is expected to approve the arrangement with Austin Travis County Integral Care on Wednesday night.

Patients -- who typically need less than 48 hours to be assessed, stabilized and referred to longer-term care or sent home -- will receive treatment at the "extended observation" center. None will stay longer than two weeks, said Dawn Handley, chief program operations officer at Integral Care. There will be 32.5 positions at the center, she said.

The center can handle minor medical issues but won't place patients in restraints or seclusion.

"This is going to be a more calming environment" than an emergency room said, King, a member of the Police Department's crisis intervention team. "And I think the level of care is going to be drastically better."

In addition, many psychiatric patients don't need hospitalization, said Ellen Richards, Integral Care's chief strategy officer, yet "we've been using the highest level of care."

"This is an incredible solution for this community and is going to fill a gap," she added. While there are short-term crisis centers where Travis County residents can go voluntarily, they don't serve people placed involuntarily, officials said.

The $4.2 million center will be built on a 10.4-acre campus where Central Health'sSoutheast Health and Wellness Center will open this fall at 2901 Montopolis Dr. It will have 16 beds and 12,000 square feet. The remaining $4.7 million from St. David's will pay for two years of operations. After that, St. David's expects to fund 20 percent, with other sources paying the rest, said Kim McPherson, a foundation program officer.

Patients will receive medication, therapy, case management and other services. Some will see psychiatrists by live video conferencing, a trend in stretching those doctors in an era of shortages, said Dr. Avrim Fishkind, the CEO of Houston-based JSA Health Telepsychiatry who helped develop Lufkin's award-winning Mental Health Emergency Center.

That's the model for the Austin center, a solution that comes nine years after health care providers, law enforcement and public officials began meeting on mental health issues. "We've had people in crisis, and there was no place to put them," said Patricia Young Brown, Central Health's president and CEO.

Austin's fast growth has stretched mental health services beyond capacity, St. David's Foundation CEO Earl Maxwell said. "This meets the definition of a community solution," he said.

Central Health provides about $8 million in taxpayer money annually for psychiatric care, most of it for inpatient beds, Young Brown said.

The average cost of a psychiatric ER visit is $986, while a day in a private psychiatric hospital is about $900, according to comparisons provided by the St. David's Foundation. While placement in a state hospital is cheaper at $401 a day than the Lufkin center (which costs $635 per day), patients stay -- on average -- eight times longer in state hospitals and face average bills of $11,629 versus $2,222 at the Lufkin center, the data shows.

It's a better deal for patients -- who are expected to pay, even when the placement is involuntary -- and taxpayers, officials said.

Last year, local law enforcement officers placed 4,000 people in emergency detention, King said.

The center is expected to serve about 1,000 people its first year, McPherson said.

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