Southwest Iowa mental health service lacks capacity for high-need patients
The Daily NonpareilFeb 08, 2017
Editor's note: This is the first part of a series.
The abrupt closure of two of
"I think we knew this was coming," said
Group homes lack the expertise, design and revenue to serve them, she said.
"Right now what's happening is that the rate from the (
As a result, patients are being held in hospitals and jails ? some for months at a time ? until beds become available at the state's remaining facilities, Watson said.
The situation is awkward for hospitals with psychiatric beds, said
"One of our biggest issues this past year has been inability to find proper placement of patients," she said. "We had a patient that was with us for 13 months."
The patient, who had come from a group home, was intellectually challenged, as well as mentally ill, and had behavior issues, McNitt said.
"There was just no place that was willing to accept him ? including the group home he came from," McNitt said. "We had another patient here at about the same time that was here for 9 months, and she ended up getting placed pretty far away" in another state.
Both were
"They were denied after the MCO decided they no longer met the criteria for inpatient acute care ? which they didn't, but we weren't going to throw them out without a safe place to send them to," she said. "There's a need out there in the community for (a place for) these patients who need a little higher level of care."
The shortage of capacity for high-need patients is statewide, McNitt said.
"We have patients that come here from all over the state of
The patients who are hardest to place are the ones that have behavior issues and can become aggressive, said
"Really, the acute care setting in a hospital is not the appropriate place for them," he said. "We sometimes will keep them for a very long time because there isn't a place to accept them."
These patients tie up beds that could be used by more suitable patients ? and tie up staff as well, because the patients require constant supervision and care, Baumert said.
"The state facilities that (were) closed have created a lack of available space for chronically mentally ill patients," he said.
Sometimes, the patient is an elderly person with advanced dementia who is agitated, Baumert said.
"There's not a lot of facilities that specialize in the care of that kind of patient," he said. "The family can't take care of them. That's a growing area of concern. I don't think the state of
Some are sent to state mental health institutes in
Closing the state's other two institutes was in keeping with the long-term push to care for patients in the least restrictive environment possible ? but the state's mental health system wasn't ready for the sudden transition, Watson said.
"I think, on paper, it makes the state look good because we closed some institutions," Watson said. "But I don't think we've fully served the clients who need the assistance ? the higher level of care."