A shortage in available beds in mental health facilities has had a draining effect on some emergency rooms in northern Colorado.
“On any given day, we are looking for placements for emergency room patients into mental health facilities,” said Janice Mierzwa, senior director of emergency services for UCHealth Northern Colorado. “It’s not unusual for us to have to keep a person here for 72 hours [the legally allowed length of an involuntary psychiatric stay] to find them a placement.”
But UCHealth’s Mountain Crest Behavioral Health Center is helping to alleviate that problem, which is delaying mental health care and creating bottlenecks in the emergency health care system.
The center has started to open additional adult psychiatric inpatient beds as part of a 15-bed expansion that will be completed in April. The addition brings the center’s capacity to a total of 41 beds at its location off East Harmony Road in Fort Collins.
“These people need to be in the right setting to be able to start therapy right away,” Mierzwa said. “It’s what’s right for the families and for the patient.”
Patients admitted to inpatient beds usually stay at Mountain Crest for three to five days, during which time they get intensive treatment that includes individual and group therapy as well as family sessions. A specific plan also is created that includes follow-up appointments and lower levels of support for when the patient leaves the facility.
“Mountain Crest provides a level of care that very few psychiatric hospitals offer,” said Monica Smith, director of behavioral health at Mountain Crest. “And our goal here is to provide the proper services in the proper place.”
Mountain Crest has beefed up its nursing staff so it can handle more acute cases, as many patients have medical as well as psychological needs, particularly the geriatric population.
“Mountain Crest has elevated their nursing care capabilities and now has the resources to handle limited IV therapy, medical detox, as well as wound care,” Mierzwa said. “This, with the added beds, is a tremendous help in placing ER patients sooner.”
In the past, when Mountain Crest was at capacity or an ER patient had medical needs along with mental health concerns, the patient could end up in a psychiatric hospital hundreds of miles from home. Such placements can create additional disruption to the patient’s life, prevent family involvement in treatment and, in the case of geriatric patients, add to their confusion and fear, Smith said.
Smith said she believes the Mountain Crest expansion will help streamline the process. She will be monitoring wait times and hopes to reduce them to less than four hours.
ER caregivers will benefit, too. Long wait times tie up nurses and technicians because patients with mental health issues often need more intensive supervision, Mierzwa said.
But it’s not only wait times that Smith is looking to change. She wants to reduce the number of people showing up at the ER for mental health services.
“We have expanded our walk-in services at Mountain Crest so patients aren’t getting that emergency room bill,” Smith said.
In 2015, Mountain Crest extended its intensive outpatient programs, adding a daytime substance use relapse prevention program in addition to its evening program. And it developed an adult psychiatric intensive outpatient program which focuses on psychiatric issues. It also added an adolescent intensive outpatient program — unique because it picks the child up from school and provides dinner and group therapy, eliminating disruption of parents’ work schedules.
“While many programs have scaled back the treatment patients receive on site, we have maintained the standards of patient- and family-centered care,” Smith said.
One more way Mountain Crest is meeting challenges is with the Mobile Assessment Team, or MAT, which is available to the community for on-site mental health assessments. These assessments, whether completed on-site at schools or physicians’ offices or at Mountain Crest, identify the level of care a person needs.
The center is also actively seeking a geriatric-specific psychiatrist, Smith said. Once that person is in place, the hope is to partner with a local nursing home to provide care to that population without removing them from their environment. Direct admission to the hospital can be arranged, avoiding an emergency room trip altogether.
On June 3, UCHealth’s Mountain Crest Behavioral Health Center will be hosting “Windows for Wellness,” an event that aims to raise funds for additional services at the center.
“Mental health is never a money-making department, but it is a highly needed service,” said Mountain Crest’s Sara Tcheshie, who is helping to coordinate the event.
The center is seeking artists to donate their time to create a window art piece that can then be donated to the fundraising event. Projects must be complete by June 1. Details of the June 3 event will be released at a later date. Contact Sara Tcheshie at 970.207.4801 for more information.