Hospital seeks end to inpatient mental health services
NORWALK — Nuvance Health wants to end inpatient mental health services at Norwalk Hospital, shifting its focus to intensive outpatient care and referring others to Danbury Hospital for inpatient treatment.
Nuvance Health, which owns Norwalk and Danbury hospitals, met with the state Office of Health Strategy Wednesday to discuss a proposal by the hospital to close inpatient mental health services. The meeting, including a one-hour public hearing portion, lasted about four hours.
In an application submitted in January to the Office of Health Strategy, the hospital sought permission to end inpatient mental health treatment, with plans to expand emergency department mental health services and increase accessibility to Intensive Outpatient Programs and adolescent services in Norwalk.
As part of the application, Nuvance said Norwalk Hospital’s inpatient mental health unit is no longer needed as the facility is continuing its work with telehealth services, an expansion of connections with local outpatient services and establishing programs to educate future generations of psychiatrists and psychologists, among other reasons.
“In January of 2021, Norwalk Hospital’s Board of Directors and then Nuvance Health Board of Directors endorsed the plan to close the Norwalk Hospital inpatient psychiatric unit, expand outpatient services and programs at Norwalk Hospital, renovate the Norwalk Hospital Emergency Department, and consolidate inpatient psychiatry services at Danbury Hospital,” the application read.
Plans to decrease the hospital’s inpatient mental health services were in the works since a 2016 internal assessment of the psychiatric care, according to the application. Nuvance Health was formed in 2019 and an additional review was conducted.
“Recommendations included expanding telepsychiatry services to improve the management of behavioral health patients and continued expansion of integrated care across the network’s primary care practices to better support and increase access for behavioral health patients and reduce crisis events,” the application history read. “Nuvance Health also determined a need to expand IOPs to increase access to higher acuity outpatient psychiatric care.”
Norwalk Hospital’s inpatient mental health unit has under-performed for years, according to Dr. Charles Herrick, chair of psychiatry for Nuvance Health.
“The current average volume is seven to eight patients and historically hovered around nine to 10 for the last 15 years, because patients can access other services in area,” Herrick said. “They go to Hall-Brook (Mental Health Services), Silver Hill (Hospital) or freestanding facilities, Stamford, Bridgeport, many ask to go to Yale and a lot of it has to do with the environment of care.”
Stamford, Bridgeport, Silver Hill and Hall-Brook hospitals are among the seven facilities that provide inpatient psychiatric treatment within 24 miles of Norwalk Hospital, according to the application documents.
By terminating inpatient services, Norwalk Hospital can dedicate more time and resources to improving outpatient services in and associated with the hospital and improve the facility’s emergency department response to mental health crises, Herrick said.
For inpatient services that may be required by Norwalk Hospital patients, a referral will be made, and transportation will be provided to Danbury Hospital, Herrick said.
The proposal would also result in financial benefits, as a day in inpatient care can costs a few thousand dollars while a day at an IOP typically costs between $200 and $300.
“The proposal intends to enable more cost effective delivery of health care in the region via two overlapping components,” the proposal documents read. The components include expanding outpatient services and consolidating inpatient psychiatric services at Danbury Hospital. Nuvance said the move will expand mental health care in Norwalk while focusing on prevention before an acute mental health crisis arises, which would also allow facilities and patients to avoid costly hospital stays, Nuvance Health CEO and President Dr. John Murphy said.
“The model we are proposing is trying to address that we get patients the care that they need before they get to the ED or have to be on an inpatient unit,” Murphy said. “Often times, I think those admissions are regrettable. If care had been provided earlier, they might’ve been avoided. This model will provide patients with care much earlier in the onset of whatever it may be even anxiety or depression. This model allows us to provide them care much sooner before they have to wait, get frustrated and go to an emergency department in crisis.”
Concerns expressed by the Office of Health Strategy commissioners included access and transportation to inpatient services in neighboring facilities and municipalities, the state of mental health care in Norwalk Hospital’s emergency department and how the hospital plans to address adolescent mental health needs.
The move to close Norwalk Hospital’s inpatient mental health services comes amid plans for a $220 million renovation and expansion project set to be completed by 2026, with the new buildings to feature an extensive maternity ward.