Facility helps, but more is needed

Central Ohio received a boost last week in the number of inpatient psychiatric beds available to people in crisis.

At the same time, advocates say they are hopeful that an upcoming change to Medicaid will further help relieve the backlog of people

forced to wait in emergency departments for hours or days before being admitted.

Columbus Springs East, which opened its doors on the Northeast Side last week, currently has 24 beds but eventually will offer as many as 72.

“We know the demand is there,” said Merissa McKinstry, chief operating officer. “As the population grows, the need for services is going to continue to grow.”

The opening brings to 345 the number of psychiatric beds central Ohio private hospitals have reserved for non-geriatric adults, according to the Ohio Department of Mental Health and Addiction Services.

They are part of about 2,600 private psychiatric beds statewide. Along with private beds are the roughly 1,100 beds in state-run hospitals, including 178 at Twin Valley Behavioral Health Center on the Hilltop, where about one-third of beds are open to the general population. Columbus Springs Dublin Columbus Springs East Fairfield Medical Center Licking Memorial Hospital/Shepherd Hill Mount Carmel Health West Hospital Nationwide Children’s Hospital Ohio Hospital for Psychiatry Ohio State University’s Wexner Medical Center/Harding Hospital OhioHealth Riverside Methodist Hospital Sequel Pomegranate Health Systems Inpatient psychiatric beds at state hospitals in central Ohio Twin Valley Behavioral Health Center Note: Roughly two-thirds of all beds in state hospitals are reserved for people referred there by courts. That’s not enough. While the system was set up to accommodate a population of about 900,000, Franklin County has grown to become the largest county in the state, with 1.2 million people, said David Royer, chief North Hilltop executive of the Alcohol, Drug and Mental Health Board of Franklin County.

Further, he said, health care must change the way it treats people with severe and persistent mental illness.

“We have to view the treatment of mental illness like we view any other illness,” Royer said. “The idea that we would have people wait hours and hours on a bed for a cardiac issue or any other kind of chronic health condition would be viewed as unacceptable.”

On Wednesday, for example, 46 people waited in central Ohio emergency settings for psychiatric beds to become available, said Jeff Klingler, president and chief executive of the Central Ohio Hospital Council.

Twenty were Medicaid patients, who had to wait for slots to open in general hospitals. They cannot receive care in freestanding mentalhealth facilities.

A change in Medicaid rules starting July 1 will allow freestanding mental-heath facilities with more than 16 beds to accept Medicaid managed-care plans for patients 21 to 64 years old.

“That should be enough psychiatric beds to meet the current needs of Franklin County,” said Dr. Pablo Hernandez, medical director of Netcare Access, which operates a crisis center and often refers patients to inpatient facilities. “I’ve been in practice since 1994. I think this is the first time I can truly say that.”

However, for the Medicaid update to lead to meaningful change, Royer said, the state Department of Medicaid should review its reimbursement structure to provide an incentive for for-profit hospitals to accept Medicaid patients.

Along with the new Columbus Springs location, SUN Behavioral Health plans to build a 144-bed hospital on the city’s North Side, Klingler said.

And the Franklin County Task Force on the Psychiatric Crisis and Emergency System is working on some pilot projects, including a tele-psychiatry program and a system that would establish better links between hospitals and outpatient care.

Also, six crisis centers are being considered in the two-year state budget now before the Ohio Senate, said Terry Russell, executive director of the Ohio chapter of the National Alliance on Mental Illness.

Still, Russell said: “The bottom line is we’ve talked a lot. We know the problem. But we really haven’t addressed it.”

He said there is a great need for outpatient beds that can help people continue to improve after they are released from hospitals and crisis centers. He likened it to the rehab centers that stroke, heart and orthopedic patients go to after hospital stays.

Right now, people are allowed short hospital stays, but then have no place to go once they are released, Russell said, adding that patients often return time and again.

NAMI Ohio is behind the push to build a mental health rehab center in Athens. It would allow patients to stay for as long as 50 days and work on a strategy for returning to the community.

Russell said he hopes it serves as a model for similar centers across the state.

“The issue here is, let’s find out what works for the sickest of the sick and just break the cycle of people going into the hospital and just going back,” he said. “People do recover from this illness, just like any other illness. But they need care.”