Press-Republican

August 12, 2013

St. Lawrence inpatient services slated to close

JEFF MEYERS
Press-Republican

PLATTSBURGH — A plan to redesign the state’s mental-health system would end inpatient services at St. Lawrence Psychiatric Center in Ogdensburg. 

Local officials in the mental-health field believe the move could benefit the North Country.

According to an extensive report on the changes released by the New York State Office of Mental Health, the St. Lawrence Adult Inpatient Unit will be transferred to regional centers in Syracuse or Albany, and the Children’s and Adolescent Inpatient Unit will be transferred to a regional center in Utica.

The plan does not need legislative approval, but the Office of Mental Health is required to provide a one-year notice to the legislature and the public before initiating the project.

Officials say the plan would save the state $20 million over a three-year transition period, which begins in July 2014.

“The general idea, of course, is to reduce the total number of state hospitals in New York state,” said Sherrie Gillette, director of Community Services for the Clinton County Mental Health and Addiction Services. 

“We have more state (mental-health) hospitals here than any other state in the country.”

COMMUNITY SERVICES

The nation began to close mental-health hospitals nationwide 40 years ago in an effort to “move all services back to the community so that people in need of hospitalization would not have to be removed from their family and home community,” Gillette added.

The recent efforts to restructure New York’s mental-health system is a continuation of those long-term efforts, she said.

“Having 24 hospitals (statewide) is an example of bygone times,” said Craig Amoth, executive director of Behavioral Health Services North in Plattsburgh.

The approaching plan would reduce that number to 15, he said. 

“For the most part, the concept makes a ton of sense.”

State hospitals provide 1 percent of the state’s mental-health services but use up to 20 percent of the costs in mental-health care, Amoth noted.

Inpatient services for adults and children are available at CVPH Medical Center, which also benefits the region heading into the revisions. 

“It’s important for us to recognize that we have a hospital for psychiatric services here in Clinton County, which is where most of our people go (for inpatient care),” Gillette said.

If beds are not available on those units, patients are transfered elsewhere.

FEW TRANSFERS

In 2012, fewer than two dozen patients were transferred from Clinton County to the St. Lawrence facility. It happened sometimes because the CVPH beds were full but more often because patients needed to stay in the hospital for a lengthy period of time, Gillette noted.

“These are patients who have a higher severity of illness and need an extended period of time (for recovery) that can’t always be accommodated at an acute-care facility (such as CVPH),” she said.

Amanda Bulris, executive director for the National Alliance on Mental Illness, feels the plan has both positive and negative implications.

“I would say that there are a number of pros and cons, but if the plan is drawn out correctly, it may mean more money for the community to provide intensive outpatient supports,” she said.

“Community investment could result in more money for outpatient services and more money for innovative, evidence-based services, like mobile crisis units.”

REGIONAL CENTERS

In the redesign, the state will create a series of Regional Centers of Excellence for inpatient mental-health services. 

Syracuse will serve as the main center for patients currently being served at St. Lawrence, but local patients will also have the option to use the Regional Center in Albany, which is a few hours closer.

The Syracuse center will have 185 inpatient beds and the Albany center 161 beds. The child and adolescent unit at Utica will add 90 beds to its current 75-bed center.

As of June 9, St. Lawrence had an inpatient census of 68 adults and nine children, according to Office of Mental Health Public Relations Director Benjamin Rosen.

“The closure (of St. Lawrence’s inpatient services) will not have a huge impact on us, but there is a need for a longer-term hospitalization option that CVPH doesn’t offer,” said Peter Trout, chief of operations for Behavioral Health Services North. 

“We will have that option available (with the state’s regional centers).”

Bulris said she likes the option this region will have to use either Syracuse or Albany for adult inpatient services.

“Currently, our people go to St. Lawrence with very little choice because of policy and restrictions,” she said. “Although the plan is that the Syracuse ‘hub’ would be our location, it doesn’t mean that our person couldn’t elect to go to Albany.”

Mental-health officials still recognize a need to improve the community’s overall services for patients, especially in outpatient services. They believe the cost savings gained from hospital closures should be directed toward improving programs where needed.

“Instead of spending our (state) budget on state hospitals, you should be reinvesting that money back into the community, so the community has the types of services as well as the capacity to manage the people who need those services,” Gillette said.

“Certainly, we need to increase our crisis services.”

“How the state is going to distribute any cost saving is the key question,” Amoth said. “We need to be able to support our community and allow our community providers to meet the community’s needs.”

Those kinds of financial decisions are not addressed in the Office of Mental Health’s report, but it is an issue that needs to be clearly considered as the plan moves forward, Amoth added.

OVERALL HEALTH

Offiicials agreed that improved funding sources for the region could also benefit the community by putting more focus on the overall health of patients with mental illness. 

Many who have more severe mental illness utilize the region’s emergency rooms for treatment of physical illnesses or injuries. A solid mental-health program would incorporate a patient’s physical wellness, they said.

“Our population is four times more likely to go to the ER for physical reasons (than people not being served by BHSN),” Trout said. 

“We need to find better ways to integrate primary care (into mental health), so we can treat the whole person.”

REDIRECTING FUNDING

Gillette also envisions a bump in support for outpatient services in the community with improved funding sources, but she also would like to see an increase in the ability to bring services to people in their homes and local communities.

Funds could also be redirected to provide more housing for people with mental illness, she added.

“The state is really being proactive in developing teams of people representing communities to really address the gaps in services in those communities,” she said.

“There will be a lot of input on what is needed to ensure people aren’t left without services.”

Most of the concerns in closing state hospitals is the loss of jobs in communities such as Ogdensburg, but the state has said that no layoffs will result from the downsizing.

St. Lawrence will continue to run its outpatient services, as well as its sexual-offender program.

Email Jeff Meyers:jmeyers@pressrepublican.com

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For More Information

To view the Office of Mental Health's report on restructuring state mental hospitals, visit http://www.omh.ny.gov/omhweb/excellence/rce/rceplan.pdf.