CON: Better resources needed to keep mental health unit running

JR Ortega By JR Ortega

April 25, 2010 at 11:05 p.m.
Updated April 25, 2010 at 11:26 p.m.

The closing of the mental health unit at Citizens Medical Center may be a sign of the times.

David Brown, the hospital's chief executive officer, didn't elect to close the One South unit. Its forced closure, he said, shows mental health care is leaning toward other services rather than inpatient care.

"It wouldn't be a smart move to reopen," Brown said.

The unit did not offer enough resources, as found in bigger units in metropolitan area, to be as effective as it could have been, Brown said.

Improved pharmaceutical drugs and more focus on outpatient services changed the face of emergency inpatient facilities, particularly the One South unit.

In 28 years, Brown has seen a unit with 40 beds and an outpatient program change to a unit with only nine beds and no outpatient program.

"One could legitimately argue that any prospective mental health patients would be better at bigger facilities," he added.

Dr. John Bouras, one of three psychiatrists to file a leave of absence from One South, said psychiatric hospitalization is the most expensive treatment for mental health patients. Successful treatments usually occur when patients are treated in a less restrictive setting, he said.

Bouras left the unit to focus more on his outpatient services, he said.

"A psychiatric hospitalization should be the last resort of a comprehensive community mental health treatment," Bouras wrote in an e-mail.

Funding for mental health, especially in Texas, is not becoming any easier, Bouras added.

Last year, the National Alliance for Mental Illness gave Texas a grade D in terms of mental health care. More recently, the Texas Department of State Health Services proposed to cut beds from four psychiatric hospitals to help with a billion-dollar budget shortfall.

Seeing changes like these in mental health make Bouras wonder if keeping an emergency inpatient unit is necessary.

"It would be great to have one," Bouras said. "But without any significant changes in the way the community funds and cares for its patients with psychiatric illness, it is like the 'need' to offer open heart surgery when we do not provide adequate resources for access to prevent and manage cardiovascular diseases."



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