Bob CollinsA Brainerd, Minn., hospital is going to test whether it’s possible for a medical facility to treat only the “good” patients with mental illness and avoid any sort of backlash with the policy that prevents those who are not voluntarily seeking help from being admitted to the hospital’s psychiatric unit.
Essentia Health may succeed with the new policy at St. Joseph’s Medical Center in Brainerd because the severely mentally ill have very little constituency.
The Star Tribune reports the hospital will no longer accept patients who are civilly committed to the 16-bed psychiatric unit. These are patients who are held involuntarily, usually because they represent a danger to themselves or someone else. Instead, the hospital will accept only those who have less serious mental health problems.
[Update: A spokesperson for Essentia says those who are involuntarily committed will still be treated in the emergency department and, if need be, the intensive care unit until they can be moved to another facility with the ability to provide care. But a common criticism of Minnesota’s mental health care system is that psychiatric patients are held in an ER, for example, but are not able to get access to the comprehensive care available in a psychiatric unit.]
The new policy is going to ripple through the entire Upper Midwest because often patients are sent to Brainerd because there are no psychiatric beds in other hospitals.
Still think the mental health system isn’t sick?
“It’s discriminatory and I’m not sure how they can get away with it,” said Dr. Barry Rittberg, an assistant professor of psychiatry at the University of Minnesota. “This sends a message that they only want the ‘nice’ patients, and that will make it more difficult for the other hospitals.”
And that’s a challenge for the other hospitals; the experts figure it could force other hospitals to limit access to care for people who seek it voluntarily. But what about people who are sick?
“These are real people. They aren’t chess pieces,” said Sue Abderholden, executive director of the National Alliance on Mental Illness of Minnesota. “And they don’t just go away because you won’t admit them.”
The Star Tribune report says the crisis in available care intensified after the Legislature passed a law in 2013 requiring people sitting in jail who are judged to be mentally ill to be hospitalized for help within 48 hours. It has forced hospitals to keep the mentally ill hospitalized longer because there’s nowhere to send them.
“They are in crisis and should not be denied treatment as if they are an inconvenience,” Human Services Commissioner Emily Piper said in a statement to the Star Tribune.
There’s no help on the horizon.
At a forum in Brainerd last month, Senate Majority Leader Paul Gazelka, R-Nisswa, said there’s no mental health reform effort coming during the 2018 legislative session (it’s not a budget year).
It was at that forum where Sen. Carrie Ruud, R-Breezy Point, revealed the hospital’s new policy while calling it “grassroots reform,” the Brainerd Dispatch reported.
The shift to voluntary patients will open up beds for local residents and make the hospital staff safer, since patients will want to be in the facility, Ruud said. It may also help alleviate the psychiatrist shortage by making the facility a more attractive place to work, she added.
There apparently is no good answer to the question of what happens to the people who are severely mentally ill?
