Hospital, law enforcement talk alternatives for mental health care
April 3, 2010 at 4 p.m.
Updated April 2, 2010 at 11:03 p.m.
The closing of the mental health unit at Citizens Medical Center is causing concerns from those who frequently used the emergent-care unit.
Thursday's forced closure of One South also has left the mental health community, law enforcement agencies and the hospital scrambling for viable options.
"It's going to have a significant effect on us," Police Chief Bruce Ure said.
Officers frequently used the unit to evaluate people who may be harmful to themselves or others.
Ure is working on a long-term contingency plan with the police department to fill the hole in the policing process.
Other options and costs are still being considered, he said.
The interim plan is to turn any person with mental distress to Gulf Bend, Ure said.
Those in need of medical and psychological attention will be sent to Citizens and then later evaluated by Gulf Bend.
"I don't believe we're going to miss a beat," he said. "Gulf Bend has assured us they're a partner in this with us. I remain confident we'll be able to provide the service that we've always provided."
Sheriff T. Michael O'Connor will contact Gulf Bend on Monday about options for deputies, but did say from what he knows now, the sheriff's office, police department and county jail will all be in trouble without the unit.
"It was the element of surprise," O'Connor said about when he found out a day before the unit closed. "From what little I know, there will be no services."
When O'Connor took over as sheriff, he noticed people in the county jail who needed treatment, not incarceration, he said.
"We've been working with the hospital and Gulf Bend for at least four or five years now on jail diversion with MHMR individuals," he said.
Not having the unit could add to an already strapped budget if people are instead incarcerated or driven by deputies to the San Antonio State Hospital, he said.
"It's going to have a costly effect," he said. "It's unacceptable to not have these services for the taxpayers in Victoria when needed."
O'Connor was not able to access information on how much the unit's shut down would cost them, he said.
One option O'Connor is looking at is training deputies and officers to be able to do some basic mental evaluation on the person themselves, he said.
Incarcerating them will undo years of jail diversion progress to an already limited space in the county jail, he said.
"The key is not necessarily pointing fingers, but that we realize the hospital has now put us on notice about the availability that is no longer there," he said. "The next thing to do is to get together. It's a must."
an unstable situation
Michael Snider has used the facility several times in the past, but its closure was something unexpected.
"We were surprised and shocked, to say the least," said Snider, a 37-year-old Victoria resident who leads a support group with the local National Alliance on Mental Illness chapter.
Snider, who suffers with mental illness but declined to say what it was, said the unit's closure will have a costly effect on its users and their families.
At least 15,000 people suffer with mental illnesses in Victoria County, he said.
"It's going to be disappointing because if you have to drive two hours, it puts a strain on families, not to mention the person going into the hospital," he said.
The nearest facilities include the San Antonio State Hospital and a unit in Houston and Corpus Christi.
Snider recalled his past experiences with the unit to be good ones.
"It was one of the better psychiatric units," he said. "This was a really good one that we hated to lose."
The only option left for families and mental illness sufferers who need emergent care is to travel two hours away.
The unit's closure was a "step in the wrong direction," Snider said.
Snider has to take the closure at face value and can only remain hopeful that things will look up in the future.
"I just wish there was more being done on the federal level for people with mental illness," he said. "It seems we're against all odds. There is so much that can be improved. Everyone is hoping, but it is kind of heartbreaking when the unit shuts down."
the hospital's cure
One option for the hospital is to recruit psychiatrists who could possibly reopen the unit in the future, but that is a long-term option, Citizens' CEO David Brown said.
The landscape of mental health is changing, making it difficult to recruit psychiatrists for inpatient services, he said.
Psychiatrists are more likely to focus on outpatient care, like what Drs. Robert Lyman, Greg Creager and John Bouras, the three psychiatrists, decided to do.
"We've gone from inpatient to more outpatient care," he said. "We now have more miracle pharmaceuticals."
When Brown first took over the hospital 28 year ago, there was 40 beds at the facility.
On Thursday, there were nine beds and only one was occupied, he said.
That patient will be transferred to another facility, Brown said.
Employees who worked at One South have filled other positions at the hospital, he said.
No one was let go.
Lyman and Creager did not return phone calls this week, but the two psychiatrists did send an e-mail statement.
"Because of the growing needs of our outpatient practice, along with a desire to meet commitments in our personal lives, we have asked for a 'leave of absence' from Citizens," the e-mail read. "We will add that the decision was not financial. Our collective incomes will drop, likely substantially.."
For now, any problems dealing with mental evaluation will be handled by Gulf Bend, said Executive Director Don Polzin.
Law enforcement needs to know that if people need physical and mental care, they have to direct them to the emergency room and then contact Gulf Bend, he said.
If the person may just have a mental issue, then they need to contact Gulf Bend.
The hospital will also call on Gulf Bend for any mental screenings.
A crisis hotline is also available, he added.
"That's demanding work," Polzin said, about working inpatient services like the psychiatrists had for several years.
The unit's closing is now water under the bridge and it is time to move forward, he said.
Polzin said he wants to take the high-road approach in getting the mental health community through this.
"We need to have a working relationship with our county hospital," he said.