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Thursday, December 27, 2007

EDITORIAL: Gaps in mental health

Lack of local inpatient care disturbing for the mentally ill

It’s a scary time to be an individual with a mental illness or to be responsible for someone who is mentally challenged in this community.

For the first time in 30 years, the only hospital open to everyone in the community, Mercy Medical Center, no longer has a designated mental health unit. That gap in mental health care provides the basis for a four-part news series that began in Wednesday’s News-Review.

The closure this fall of Mercy’s Behavioral Health Unit leaves just three beds in the emergency department dedicated for people with mental illnesses. Anyone who needs more than emergency care will be sent to a hospital out of the area that has an acute care unit. That would take the individual who’s already suffering farther away from home, family and other support services.

How much of a problem is that for Douglas County residents? The number of patients seen by Douglas County Mental Health likely provides a glimpse. Just over 3,600 people — including 1,129 between the ages of 0-17 — sought help from the county in 2006. About one-third needed medication services while most needed outpatient treatment.

These are the folks who, in crisis situations, would turn to Mercy for extended stays in the BHU.

Mercy has made its case clear for closing the inpatient unit. It was running the highest deficit of any hospital mental health unit in the state, having lost money in each of the past 10 years. Losses in 2006 were $2 million, according to hospital officials.

The low rate of reimbursement for mental health services is one of the problems facing Mercy and the county alike. Jefferson Behavioral Health, based in Grants Pass, is responsible for setting reimbursement rates and distributing state funds for mental health care in a six-county region, but Douglas County has frequently felt shorted.

Just recently, for example, the county asked if some of the funding that would have gone to Mercy’s inpatient beds could be shifted to the county for additional community services, but JBH denied the request.

Such actions have Douglas County commissioners looking for other organizations to support the county instead of JBH. If indeed JBH is not meeting the county’s needs, this sounds like a prudent course of action to take.

It would be great if the state could step in and solve this reimbursement problem, but it has funding problems of its own as it seeks to replace the decaying state hospital with two new facilities.

Both the state and the county appear to realize the goal is to provide preventive treatment for the mentally ill before they are in need of inpatient care or they end up on the streets or in jail.

To that end, Douglas County is setting its priorities for mental health patients and working to come up with a plan for a comprehensive approach to mental health treatment. Officials are even looking into offering volunteer counselors to reach those most often neglected — people who have no private insurance coverage and who don’t qualify for the Oregon Health Plan.

It’s encouraging to see plans evolve, but the closure of Mercy’s BHU remains a devastating loss to the mentally ill in Douglas County.


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