Spotlight Mental Illness ‘The entire system is broken’ In wake of Taunton killings, advocates argue need for more mental health services

Arthur “AJ” DaRosa, the 28-year-old man who had suicidal thoughts and sought treatment, but was released within hours from Morton Hospital and then went on a deadly stabbing rampage, was one of thousands in Massachusetts waiting for mental health care in a system advocates say has suffered years of cuts.

“Everyone can point fingers at someone else, but in reality the entire system is broken,” said Karen Coughlin, vice president of the Massachusetts Nurses Association (MNA) and a nurse at Taunton State Hospital. “There is no longer a safety net.”

Across Massachusetts, as many of 40,000 patients a year are “boarding” in overcrowded emergency departments, waiting for care from several hours to days and weeks, according to a Mental Health Advisory Commission study.

New Bedford and Fall River are among the hardest hit communities in the state, facing the highest demand for mental health services, data from the Massachusetts Health Policy Commission found. Between 2010 and 2014, behavioral health visits to emergency departments increased by 23.7 percent in the state. But in New Bedford that number jumped by 48 percent in the last four years. In Fall River, it rose by 53 percent.

“We have a need for all kinds of services and beds in Southeastern Mass and across the state,” Coughlin said.

Over the last 20 years, mental health advocates said, the industry has continually been on the chopping block when it comes time for budget cuts.

Over the last eight years, funding for the Department of Mental Health has decreased by 37.1 percent. In 2001, $50.9 million was reserved for mental health. By 2016, $28.9 million was set aside for it.

Both inpatient and outpatient services have suffered cutbacks, advocates said. Most recently, former Gov. Deval Patrick proposed shuttering inpatient services at Taunton State Hospital, one of six mental health facilities in the state that cares for people with acute and chronic psychiatric problems. The hospital’s beds dropped from 170 to 45.

In New Bedford and Fall River, Seven Hills cut outpatient services this summer, estimated to impact 200 patients over the next year, due to financial losses leaders attribute to inadequate fee-for-service reimbursement rates for services.

“There needs to be a dramatic increase in the number of beds and services,” said David Schildmeier, spokesman for the MNA. “We’ve cut a number of inpatient beds and we don’t have the outpatient services or community services to augment that care. In all areas of the system, there has been a problem.”

The region’s raging opioid crisis is also tied into mental health, advocates said. Many patients who are mentally ill have a dual diagnosis of a mental health issue and a substance abuse problem at times arising from their self-medication, Schildmeier said.

The MNA has bills pending before the Legislature to increase the care people suffering with mental illness receive.

One bill, sponsored by Sen. Marc Pacheco, D-Taunton, and Rep. Patricia Haddad, D-Somerset, would create a pilot program at Taunton State Hospital to transfer medically stable, high acuity behavioral health and dual diagnosis patients away from overcrowded emergency departments until an appropriate placement is found to meet the patient’s needs.

A second bill would create a “Difficult to Manage” unit for women and reinstate the “Difficult to Manage” Unit for men, both within the Department of Mental Health. These units would be highly structured environments with specially trained staff to provide care to those patients with acute mental illness, who can be extremely violent and pose a danger to other patients and staff, advocates said.

“I definitely think there needs to be changes in the system,” said the Rev. David Lima, executive director of the Interchurch Council in New Bedford. “There is a definite lack of services. It’s not just the places where care can be given. It’s a lack of clinicians.”

“In the last few years, we’ve had all these instances of high crime — it’s not even an issue of gun control — you have high crime, massacres, deaths. Usually the perpetrator has a history of mental illness,” Lima said.

Evidence of a need for services in the region is the new Southcoast Behavioral Health facility on Faunce Corner Road in Dartmouth that serves as a referral specialty hospital for patients across the state, said Kevin R. Burchill, chief executive officer.

The locked facility treats patients who are at risk of hurting themselves or others, which is known as a Chapter 123 Section 12 commitment. Most patients will agree to commit themselves voluntarily for 72 hours. After which, doctors will determine whether they are ready to go or whether to petition the district court to have them stay longer, known as Section 7. A probate judge would make the final decision.

In Dartmouth, 72 beds for adults opened at the less than a year-old facility with 24 geriatric beds slated for July and another 24 for children expected in the fall.

On Friday morning, the 77,000-square-foot facility had 61 of its 72 beds full.

Haddad said there have been efforts under the Baker administration to increase resources for mental health. Recently, Taunton State Hospital has opened a 15-bed unit for women who fall under Section 35. Thirty more beds for women are slated to open this summer. Section 35 is the civil commitment of substance abusers, which can last 30, 60, or 90 days.

“Over the years, since I’ve become deeply involved, we’ve consistently put more money into services,” Haddad said. “Is it a question where we need more money or redistribution of current funds and making sure services are provided so there are no gaps?”

Burchill agreed that Baker’s administration has been more dedicated to mental health than previous administrations.

“I think Gov. Baker has done a nice job working with the Executive Office of Health and Human Services,” he said.

Burchill added, “There is a greater awareness of mental health issues in the community.”