Page 8 - Healthcare News Mar/Apr 2021

MENTAL HEALTH CONT’D Mental Block
New Inpatient Beds Will Meet a Long-time Regional Need
BTy JOSEPH BEDNAR
he health anxieties, economic stresses,
substance abuse, and feelings of isolation
exacerbated by COVID-19 aren’t exactly new, Dr. Barry Sarvet says. And they won’t fade when the pandemic does.
Partners New England (HPNE), which committed to keeping inpatient beds open — and Baystate moved forward with its project — the stopgap made sense as a longer-term solution, although HMC could revisit a standalone behavioral-health hospital at some point in the future, Hatiras said.
Baystate’s project, meanwhile, will include 150
Providence to HPNE, which provided some manage- ment services at the facility from 2011 to 2014, and will operate the facility under the name MiraVista Behavioral Health. In doing so, it will resume opera- tions of numerous outpatient programs, as well as including up to 84 inpatient psychiatric beds.
“At the time we put forth the plan to build a new behavioral-health hospital, everyone else had pretty much abandoned any
behavioral-health expansion,” Hatiras told HCN. “People were shrinking programs; Providence was closing down their campus, and Baystate had put their plans on hold indefinitely. We decided we needed to do some- thing to service the region. Since then, Baystate resurrected their plan to de- velop the old Geriatric Authority site.”
“Prior to the pandemic — and it’s easy to forget this now — we had an enormous amount of stress in our communities related to
poverty, homelessness, eco-
nomic struggles ... people just
facing an enormous amount
of stress in their lives,” said the
chair of Psychiatry at Baystate
Health. “We had underem-
ployment, unemployment, an
opioid epidemic. It’s a very dis-
tressed community with a lot
of long-term struggles, a lot of
psychosocial stress. Every psy-
chiatric disorder is influenced
by environmental stresses, and those aren’t getting better. We need to pay more attention to them after the pandemic.”
Well before COVID-19, Sarvet noted, the region’s mental-health needs laid bare a shortage of inpatient beds for patients who need more help than outpa- tient visits can provide. It’s why Baystate announced a joint venture with Kindred Behavioral Health last summer to build and operate a $43 million behavior- al-health hospital for the region, set to open in 2022. The hospital will be located on the former Holyoke Geriatric Authority site on Lower Westfield Road in Holyoke.
Holyoke Medical Center (HMC) had revealed a similar proposal in March 2020 to build a $40.6 mil- lion, 84-bed behavioral-health facility on its campus. But when Baystate’s plans came online, and the threatened closure of 74 inpatient beds at Providence Behavioral Health Hospital were saved by a change in ownership, HMC reverted to an earlier plan, to repurpose two of its existing units for behavioral health.
“We were concerned about providing a solution to get beds online as the state was developing guidelines for all hospitals to incentivize an increase in behav- ioral-health beds,” said Spiros Hatiras, president and CEO of HMC and Valley Health Systems.
The process of converting two units to behavioral health — an adult unit and one with a likely geriatric focus — began in October and will be finished by late April, and will add 34 new beds to the existing 20 at the hospital, more than doubling the total to 54. In doing so, it provides a more immediate solution to regional bed shortages, avoiding the need for a lengthy construction period (HMC’s new hospital was also expected to open in late 2022).
The internal repurposing of units had been conceived as a stopgap measure, but when Trinity Health announced the sale of Providence to Health
“
Every psychiatric disorder is influenced by environmental
stresses, and those aren’t
getting better.”
beds — 120 of them part of the original plan. The system has also contracted with the state Department of Mental Health to operate a 30-bed, long-term con- tinuing-care unit for chronically mentally ill people who need a longer time in the hospital to stabilize before returning to the community, Sarvet explained.
This state-funded program, not accessible to regular referrals, was launched after the closures of Northampton State Hospital and other facilities like it. “Some patients need longer-term care, and this offers a length of stay to support people who don’t benefit from short-term hospitalization,” Sarvet said, adding that the DMH unit will be physically con- nected to the new hospital, but offer its own unique resources.
The recent moves come as no surprise at a time when state health officials have been incentivizing hospitals to open
up behavioral-health beds in the wake of a sharp increase in cases due partly to the pandemic.
However, “we had a concern that what seemed like no beds could potentally become too many beds,” Hatiras explained. He disagrees with Marylou Sudders, secretary of Health and Human Services for the Commonwealth, who has said there can never be too many beds because the state has so many needs. Rather, he noted, “demand may be greater now than it will be a year from now as we move away from the pandemic spike; we might see demand go down.”
Two other factors, both geographic, also played
DR. BARRYSARVET
“New beds will be
needed over the long
term,” he said, speaking
of the project as a whole.
“We have had quite a
shortage for many years,
prior to the potential clo-
sure of Providence and
prior to the pandemic.
This substantial increase
in needs is reflected
in emergency-room
visits from patients with
a mental-health crisis. And we certainly see evidence that this isn’t a short-term blip, but part of a longer- term trend that predated the pandemic.”
Multiple Pivots
The prospect of any additional behavioral-health beds in the region is certainly a turnaround from a year ago, when Trinity Health announced it would close 74 inpatient beds at Providence Behavioral Health Hospital.
However, two months ago, the health system sold
“
We were concerned about providing a solution to get beds
online as the state was developing
guidelines for all hospitals
to incentivize an increase in
behavioral-health beds.” SPIROS HATIRAS
into the decision to scale down HMC’s behavioral- health expansion. One is that HMC, Baystate, and Providence would have been providing around
225 beds within a three-mile radius of each other, and though the need for services is great statewide, there’s only so far patients and families will be will- ing or able to go to seek access to treatment — not to mention the difficulty of recruiting more physicians, nurses, and ancillary staff to such a concentrated area.
“We might find ourselves very quickly in a situa- tion where we might not be able to staff those beds.
8 WWW.HEALTHCARENEWS.COM MARCH/APRIL 2021