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Herald News (Passaic County, NJ)
St. Mary’s asks to shut its psychiatric unit;
Mental health advocates say closure would cause crisis
By MEREDITH MANDELL,
North Jersey Media Group
PASSAIC, N.J. — A move by St. Mary’s Hospital to close its psychiatric unit could leave Passaic County without a place to involuntarily commit residents in crisis.
The hospital has filed an application with the state to shut its facility, according to Thomas Slater, a spokesman with the state Department of Health and Senior Services. Slater said the department has received a certificate-of-need application from St. Mary’s but that it is incomplete. Such applications show how the loss of health-care services will affect the surrounding community.
“Once it’s deemed complete, it goes to the state Health Planning Board, which then makes a recommendation to the commissioner, who makes a final decision,” Slater said. “As we go through this process, our No. 1 priority is access to services. We need to let this process play out.”
He said it was too early to say whether the state would decide to keep St. Mary’s 38 beds in Passaic County.
The decision will affect thousands, based on hospital admissions and crisis-center calls. There will be no public hearing on the matter, Slater said.
Hospital officials didn’t deny filing a request with the state to eliminate the 38 beds at its 211 Pennington Ave. campus, but said the decisions about what would happen next would be left to the state.
“We trust the DOH will make the best possible decision for the future of this program. We are now acting on their orders, when they should come,” hospital spokesman Erik Ramos said in an e-mailed statement.
Ramos denied that the decision to close the unit was related to the hospital’s financial concerns.
But Jeanette Gabriel, a representative for the nurses union JNESO, said hospital administrators held meetings last week with employees to talk about the psychiatric ward.
“They don’t have enough money to continue running the psych ward,” Gabriel said. The psychiatric unit employs about 70 people. Gabriel said layoffs are now a concern.
In the past, hospital officials have said their cash reserves are short and that they had counted on $20 million from the sale of the Pennington Avenue building to move the psychiatric unit to the main Boulevard campus. But the building remains unsold.
Behavioral-health advocates say that if St. Mary’s shuts its psychiatric unit, it will create a serious void of access to health-care services for the mentally ill in Passaic County.
An estimated 100,000 residents in Passaic County suffer mental health disorders, according to Francine Vince, the county’s mental health administrator. St. Mary’s is home to the only psychiatric screening center and the only hospital with legal authority in the county to have a patient involuntarily committed.
That step is for people “who are in crisis and they can’t really make decisions on their own,” said Michelle Borden, associate executive director of NewBridge, a non-profit organization providing outpatient mental-health and drug-addiction services in Passaic County.
“Having involuntary psychiatric beds in our community is a way for families to be part of the treatment. If we don’t have these beds in our community, that means we have to send people experiencing a psychiatric crisis to another county,” Borden said.
Former patients and advocates emphasized the importance of keeping beds - both voluntary and involuntary - in Passaic County. They said moving patients far from home and out of familiar circumstances can affect their ability to recover.
In 2007, the hospital received 979 admissions. The hospital is home to the county’s Mobile Crisis Unit, a 24-hour team of screeners who move throughout the county to evaluate residents. Additionally, it has a crisis-intervention hot line that gets about 14,000 calls a year, Ramos said. The hospital is also where the Passaic County Sheriff’s Department usually takes mentally ill inmates. On Wednesday, sheriff’s spokesman Bill Maer said often inmates with court orders to be screened for mental health issues are sent to St. Mary’s.
“We certainly are monitoring the situation, and once the dust settles, we certainly will make the appropriate decision about where to take patients,” Maer said. “We’ll factor in location and costs, and certainly proximity to Paterson is important” because officers must accompany inmates.
But mental advocates fear that nearby hospitals may not be able to handle the influx of patients if St. Mary’s closes its doors. Experts say that the closure of hospitals in the county and across the state in recent years has had a devastating impact on the mentally ill. Five hospitals have closed across the state over 18 months, including Barnert Hospital and PBI Regional Medical Center in Passaic County. When Barnert closed earlier this year, its 825 patients who received psychiatric counseling and HIV treatment were referred to St. Joseph’s Regional Medical Center and hospitals in Bergen County. Some former Barnert employees said they couldn’t reach dozens of their patients to discuss treatment plans, and others simply didn’t get their medications.
“It’s sort of an inventory game the state is playing with people,” said Joe Gutstein, a member of the state’s mental health board. “It’s musical chairs. When you’re stretched in one place, you’re moved to another. When one part of the system is really stressed, that’s tough on family and friends.”
Gutstein said the closure of St. Mary’s could affect Bergen Regional Medical Center in Paramus, where, he said, some patients wait days to get a bed. He said that in the last fiscal year, Bergen Regional had 4,533 admissions to its inpatient psych unit.
Sometimes, he said, hospitals discharge schizophrenics and those with bipolar disorder too early and simply give them money for a bus pass and tell them to find a homeless shelter.
Marie Threlfall, a former patient at St. Mary’s who now volunteers there with her dog, Cassie, said being close to home during her hospitalization made all the difference in the world. Ten years ago, the Lyndhurst resident voluntarily checked herself into an upscale private hospital in Belle Mead, in Somerset County, upon the recommendation of her psychiatrist. She said she suffered from severe depression and panic disorder. There, Threlfall had a private shower, a blow dryer and a salad bar at dinnertime.
“But it didn’t matter,” she said. “I felt totally disconnected from my home and family.”
She said her husband could not visit her because Belle Mead was more than an hour’s drive from home. He had a full-time job and had to take care of their three children.
“When a family member is disabled in a hospital, the other family member has to pick up the slack,” she said. “How do they do that, when they have to drive far away to visit a loved one?”
She subsequently went to St. Mary’s, where she didn’t have the same amenities but was able to recover.
“I was much happier,” she said.
Copyright 2008 North Jersey Media Group Inc.