In an attempt to lighten an increasing demand for mental health care, leaders at Integris Health say they’ve increased the number of inpatient adult psychiatric beds available at their facilities, responding to a recent closure of a large facility in Bethany.
Integris will open a mental health unit at Southwest Medical Center in late June to treat residents 55 and older and has remodeled a unit at its Spencer mental health facility to include 24 adult inpatient beds for residents ages 18 to 65.
Dr. R. Murali Krishna, president, chief operating officer and medical director of Integris Mental Health, said that after Deaconess Hospital announced it would close its Bethany hospital with roughly 60 inpatient adult psychiatric beds, Integris leadership decided to help replace the lost care.
“We as Integris Health are responding to the crisis and the lack of enough adult mental health beds in Oklahoma, especially the Oklahoma City area,” Krishna said. “Deaconess Hospital closed their units in the early part of the year, and that has caused a significant problem for a lot of the patients who needed inpatient care.”
The demand for mental health care in Oklahoma is high, because Oklahoma has the second-highest rate of adults with serious mental illness in the nation, according to the federal Substance Abuse and Mental Health Services Administration.
A majority of Oklahoma adults who need mental health services — about 70 percent — do not get them, according to the state’s mental health agency. Additionally, the state has the 13th-highest suicide rate in the nation.
Krishna said after researching community need, Integris identified that it needed to focus on the three most prevalent health issues that Oklahomans face — obesity, heart disease and mental health concerns.
“Mental illness is poorly understood by most people, not only from the stigma standpoint but also not having an adequate understanding that these (are) brain disorders,” said Krishna, who serves on the state’s Board of Health. “Just like you have kidney, heart and lung diseases, these are disorders of a main organ of the body — the brain.”
Closure in Bethany
Deaconess Hospital announced in December that it would close its Bethany location, which included its mental health unit that could serve about 60 residents.
Deaconess cited a decline in reimbursements and demand for inpatient hospital care as reasons to close its Bethany location.
Since that time, Integris has worked to renovate a medical surgical unit at Southwest Medical Center to serve as a psychiatric unit for residents 55 and older. The floor will have 24 beds available to treat these adult patients and will host an open house and ribbon cutting Tuesday. The unit replaced about 19 beds that were at Deaconess for geriatric patients.
Staff at Southwest will treat patients not only for dementia related to behavioral health issues, but also will focus on helping residents who are struggling with depression and other mental health issues.
Krishna said, for example, older men who are lonely are at high risk for suicide.
“They complete suicide several times more successfully than the women,” he said.
Meanwhile, Integris also renovated the north end of its Spencer mental health facility, converting beds for children to 24 adult beds for adults ages 18 to 65. This replaced some of about 33 adult beds lost at the Deaconess Bethany facility.
The unit became operational May 1, although it isn’t operating fully until Integris is able to hire another psychiatrist. The shortage of psychiatrists in Oklahoma and nationwide has made finding a doctor difficult, Krishna said.
The facility also has 93 residential beds for children and adolescents. They stay an average of six to nine months, although some children had been at the facility for more than a year.
The expansions at Integris will help lift the stress placed on the Oklahoma City metro’s emergency rooms, especially after Deaconess’ closure, Krishna said.
A national problem
Nationwide, emergency rooms have become an increasingly common place for people in mental health crises to seek care.
A study by the American Hospital Association found that this increase is somewhat attributable to a decreasing amount of inpatient beds and decreases in the amount of state money allocated for mental health.
Emergency room visits involving a primary diagnosis of mental illness or substance abuse disorder increased from 4.2 million in 2006 to more than 5 million visits in 2009, according to the association.
“Due to this increased utilization and a shortage of beds, emergency department boarding — the practice in which admitted patients are held in the emergency department until inpatient beds become available — is growing for patients with behavioral health care needs at hospitals,” according to a 2012 American Hospital Association report.
A majority of emergency room medical directors report that their hospitals board these patients, although it can adversely affect patients with mental health disorders, according to the association.
Krishna said he has heard stories of patients who had attempted suicide having to stay in hospital intensive care units, even after they’ve recovered physically, because there weren’t mental health beds available to transfer them to.
That costs thousands of unnecessary dollars to both the patient, their family and the hospital, he said.
“When you don’t treat these disorders, they don’t just go away,” Krishna said. “We pay a price as a hospital ... One physician was telling me that (for) 72 hours they had to keep a patient in the emergency room. Somewhere in the state they couldn’t find a place to send a patient, and that costs thousands and thousands of dollars in staffing.”