Victoria hospital unit for mentally ill closes

Sept. 22--A hospital unit that treated low risk mentally ill patients closed Wednesday after running $150,000 in the red in just three months.

Neither it nor the unit before it could accept mentally ill patients a judge committed involuntarily, though.

That's because neither six-bed unit was locked, so mentally ill patients who need to be hospitalized will continue to be driven at least 100 miles away, creating a burden for them, their families, emergency rooms and law enforcement.

"The community tends to get hysterical about these kinds of things," said Lane Johnson, the chief of clinical services at the Gulf Bend Center, which ran both units. "What I want to communicate is that in a lot of ways, this is just another day in the business of being a community health center as we work within the resources and available programs and try to be good stewards of the monies. We're making a shift here. It's not really a major change."

The unit, which was housed on the sixth floor of Citizens Medical Center, was called the crisis respite unit.

It opened in July and could treat patients for up to 14 days.

Before, it was known as the extended observation unit.

The extended observation unit treated the mentally ill in crisis for up to 48 hours.

It opened, closed to address the Texas Department of State Health Services' concerns about staffing and equipment, and reopened in 2014.

Gulf Bend changed the extended observation unit to a crisis respite unit because it thought it would be less costly.

It cost Gulf Bend about $1.3 million to run the extended observation unit because it required more staff and assessments, Johnson said then.

For Gulf Bend to break even with the crisis respite unit, it needed to serve 28 patients per month. It served about 12 per month, Gulf Bend Executive Director Jeff Tunnell said.

Johnson said Gulf Bend received numerous referrals to the crisis respite unit from local emergency rooms, but could not accept some patients because they needed to detox or had some other medical condition, such as high blood pressure or untreated diabetes, that would need to be more closely monitored.

The crisis respite unit had one nurse who worked during the daytime and patients could see a psychiatrist by using televideo conferencing software.

The closure does not affect Citizens' employees, and Gulf Bend will continue to provide crisis mental health assessments to Citizens' patients in the ER, Citizens' CEO Mike Olson said.

Five people worked at the crisis respite unit full time. Seven people worked there part time. They are Gulf Bend employees.

"Nobody has been laid off," Tunnell said. "The normal process is we have several openings that they will apply for. We will very quickly run them through the application and interview process, and it's also a chance for the staff, if this is not what they want or if this doesn't fit their needs, for them to transition as well."

Tunnell added Gulf Bend has not broken its lease at Citizens and will work to find other ways to address the need for inpatient hospital beds for the mentally ill with the Health and Human Services Commission.

He expects the Commission will come up with some ideas in a few weeks.

Johnson said in the meantime, Gulf Bend, which serves the indigent and those on Medicaid in the seven-county region, will be more proactive.

"One question is can we hospitalize fewer people? I think the answer is yes, if you can have the right kinds of programs. We're building some of those programs, but these things take some time to take effect," he said.

Tunnell added a group created by Gulf Bend will also try to get the legislature to better understand the mental health needs of a rural community.

He said in some ways, that is why the crisis respite unit closed. The formula the state uses to reimburse Gulf Bend for services there was suited more for an urban community.

Victoria has not had a locked inpatient mental health treatment center since 2010.

That's when Citizens closed One South after it, too, lost more money than it earned.

Daniel Rodriguez, who used to work for Gulf Bend and helped set up the extended observation unit in 2014, said it was a missed opportunity.

"The intent was good and the cause was good, but the follow-through lacked as it was never a locked facility, and there was never an onsite psychiatrist. The needs being met were respite needs," said Rodriguez, who is now the co-founder of Believe Behavioral Health, a counseling center in Victoria.

Dr. Wayne Goff, who retired from practicing psychiatry more than 10 years ago, said it has been surreal watching the community regress in how it treats the mentally ill.

"If you just look at the dollars and cents, there's a lot of things we wouldn't be doing anymore," he said. "Take the fire department. Does the fire department pay for itself? No, but the community knows we have to have it, so they pay for it, and they get what they pay for, and they don't make a profit."

Others dared not dream of ever having a locked inpatient mental health treatment center again.

Johnson thought if one were to open, it would likely need to be privately run.

Dr. Robert Lyman, a psychiatrist who worked for Gulf Bend and then at One South, said hospitalizations could decrease if the mentally ill had quicker access to treatment.

He said that will take attracting more psychiatrists to the area as well as providing more funding to Gulf Bend. Gulf Bend has one psychiatrist seeing patients with severe depression, bipolar disorder and schizophrenia at its outpatient clinic.

Before switching to a new scheduling program this summer, the wait time for new Gulf Bend patients was about six months.

"I think they do a good job on crisis, but that doesn't necessarily mean someone gets ongoing services quickly. That's a slower process," Lyman said.

Tunnell said Gulf Bend has not lost hope it will find a way to serve people with acute mental health needs.

"For a lot of people, this is out of sight and out of mind until it happens to their friend or family member," he said.

Reporter Laura Garcia contributed to this story.

___

(c)2016 Victoria Advocate (Victoria, Texas)

Visit Victoria Advocate (Victoria, Texas) at www.victoriaadvocate.com

Distributed by Tribune Content Agency, LLC.