PDA

View Full Version : Oct. 11, 2007: Decision on psychiatric care draws opposition



Record-Journal
10-11-2007, 01:29 AM
MERIDEN -- MidState Medical Center’s plan to shut down its inpatient psychiatric unit has drawn significant in-house opposition.

“It will be a disservice to the community,” said Dr. Richard H. Anderson, chief of the hospital’s psychiatric division. Anderson said he plans to speak against the proposal at a public hearing in Hartford next week.

A recent meeting with 10 MidState-affiliated psychiatrists showed they felt the same way, he said.

“None of them were for it,” he said.
“We think it will be a disservice to the community,” Anderson said. “We think it will lead to a bottleneck in the emergency room.”

The plan to close the six-bed inpatient psychiatric unit is part of MidState’s proposed $45 million expansion, the largest for the hospital since it opened on Lewis Avenue in 1998.

The expansion includes an enlarged emergency department and a 30-bed inpatient pavilion, bringing the hospital’s inpatient bed count to 162.

MidState intends to eliminate the inpatient psychiatric unit and transfer long-term patients to the Institute of Living, which specializes in psychiatric care. The Institute of Living is part of Hartford Hospital, MidState’s affiliate.

Under the plan, MidState would double its capacity to treat psychiatric and behavioral health patients in the emergency department, allowing the hospital to “focus our resources at the moment of crisis,” said Lucille A. Janatka, MidState’s president and chief executive.

“What we’re doing is keeping up with the changes in practice,” Janatka said. “We have a great opportunity with the Institute of Living, which is one of the primary research facilities on the East Coast.”

A small hospital cannot provide such services, she said. “I believe it’s a quality issue,” she said, “and it’s time for us to deal with it.”

The state Office of Health Care Access has until Nov. 23 to rule on the expansion proposal. A public hearing, required because the project cost is more than $20 million, is set for Wednesday at 10 a.m.

To speak against the proposal, Anderson must apply for intervenor status. As an expert witness, Anderson’s deadline to apply is Friday.

“I feel bad about it,” Janatka said. “I wish everybody could share the same vision. But I’m glad they feel comfortable speaking their mind. That’s why there’s a commission.”

The state can modify the hospital’s plan by approving parts of it and denying others, said Carolyn Treiss, a spokeswoman for the Office of Health Care Access.

As of Wednesday, there were no intervenors, people scheduled to speak either for or against the proposal, Treiss said. Intervenors can be limited to offering a statement or given the ability to cross-examine the applicant, she said.

In Connecticut, 22 of 29 acute-care hospitals offer inpatient psychiatric care, including MidState, said Patty Charvet, a spokeswoman for the Connecticut Hospital Association.

“For a hospital of comparable size, I don’t know of any that don’t have a psychiatric unit,” Anderson said.

Anderson has been with Meriden’s hospital since 1981. At MidState’s precursor, Veterans Memorial Medical Center, there had once been a 20-bed inpatient unit, he said. That was trimmed to 10 beds about five years ago and then to the current six beds.

Even a small unit is invaluable, Anderson said.
“It acts as a safety valve,” he said. “It is something we can rely on instead of letting a patient languish in the emergency room.”

“In many cases, it will be tough to send these people to any hospital but ours,” Anderson said.

Patients who wind up in the unit often have chronic conditions. Many have associated medical conditions or a dual diagnosis, and many lack health insurance coverage, Anderson said.

“It’s rare for a psychiatric unit to run in the black,” he said, “but that doesn’t mean there isn’t a necessity for a psychiatric unit.”

Janatka said the decision was “a quality issue — not a financial issue — of what they could have access to that we can’t give them here.”

“Lots of times we want things to stay the way they’ve always been,” she said. “It’s time to have a vision for the future.”

MidState filed its certificate of need, or explanation of its proposal, with the state in July. Janatka did not talk to the psychiatric division about the elimination of the inpatient unit until after the certificate of need had been filed.

“I think we were just dumbfounded,” Anderson said, “and at that time we didn’t know about the certificate of need or the hearing.”

Anderson said he just recently heard about the public hearing, and has had to “scramble to get all the information together to apply” to speak against it.

BillCarson436
10-11-2007, 07:49 AM
Hello....

I couldn't reply to the poll because there are two issues here that
I have had to consider.

#1 I have the knee-jerk decision that it's not a great idea to put
" disturbed " patients in with the other patients.

#2 I remember a young girl that tried to take her life ( depressed
teen ) and Mid State offered her a place to recover.. surrounded
by Medical staff and family which turned her life around. Had she
just been treated in the Emergency Room the results may have not
have turned out as they did.

So... put on a scale... the balance, IMHO, would tip towards keeping
the unit there. To save one young girl outweighs the need to come
into the modern age and shut down this service.

collie
10-11-2007, 10:32 AM
If Midstate closes the small psych ward, there will be no place for "disturbed" patients other than the E.R. I personally think more ER patients with mental health issues, especially the uninsured, will be discharged and not taken to the Institute of Living. Mental health care has declined over the past few decades in terms of accessibility and availability. I applaud the doctor for making the effort to speak out in opposition; hope he makes it to the hearing and Midstate reconsiders. Case in point, does anyone think whatever hospital took "care" of the grandmother from New Britain recently should have discharged her after the 911 call she made stating she had killed her two year old grandson and wanted the police to kill her. She made it clear she was mentally ill and suicidal. I wonder if that hospital, too, had "closed" its psych ward.

jma
10-11-2007, 08:05 PM
I agree that the need for psychiatric care is clearly there, and Midstate has a responsibility to address that need. I also feel that having the tiny psych ward off the ER is both a disservice to the psych patients and other patients.
I recently had to take my elderly father to the ER. Since there is a lack of rooms, we sat in the hallway next to the psych ward. The screaming, swearing, and outrageous behavior didn't make it easier on my father. Intellectually, I knew the patients couldn't help themselves. On a personal level, I was ready to do battle to protect my father.
I think a separate entrance and wing for the psych patients and detox patients would create a better atmosphere in general. It would also allow those patients a bit more dignity.
Either way, Midstate needs to step up to the plate, address the needs of the ENTIRE community, and not pass the buck to another facility.

Fit 2 Print
10-12-2007, 04:30 PM
MidState is supposed to be for EVERYone, no one refused who needs medical care in all its many forms.