Hospitals, county want to open psychiatric center to relieve crowded ERs

On any given day, as many as six psychiatric patients seek treatment in the emergency department at Santa Rosa Memorial Hospital. On average, they stay there for two to three days, compared to two to six hours for patients being treated for a physical condition, hospital officials said.

Such lengthy stays of mental health patients cause a bottleneck that leads to overcrowding in Memorial hospital’s emergency department, and sometimes forces the medical team to treat people in the hallways, said Leah Gehri, the hospital’s director of nursing operations and emergency services.

What’s more, she said, emergency departments are not ideal for taking care of people going through acute psychiatric episodes.

The lights are always on and there’s a lot of noise, plus the activity can be frenetic with constant foot traffic of doctors, nurses, paramedics and other medical staff.

At the heart of that emergency care bottleneck at area hospitals is the lack of inpatient psychiatric centers in Sonoma County where people can be admitted for lengthy periods, Gehri said. The shortage of psychiatric hospital beds means people remain longer in hospital emergency departments, as well as at the county-run center known as the crisis stabilization unit.

If Memorial doesn’t have enough beds for mental health patients they are held longer at the county’s crisis center and “that backlogs and affects our emergency department” of about a dozen beds, said Dan Schurman, community health investment manager for Providence St. Joseph Sonoma County, which runs the hospital.

This week, the county took a critical step toward a solution to a major problem, which has burdened the community for over a decade since the closure of two Santa Rosa psychiatric hospitals.

The Sonoma County Board of Supervisors on Monday accepted a contribution of $624,999 from the three health care companies that operate the county’s largest hospitals: Kaiser Permanente, Sutter Santa Rosa Medical Center and Memorial hospital.

The donation is a one-time contribution - with each hospital giving $208,333 - to help pay for the first-year operating costs of a new psychiatric health center for North Bay residents. County health department officials are working with Northern California mental health services provider Crestwood Behavioral Health to establish a 16-bed regional psychiatric health center that officials say could ease overcrowding at local hospital emergency departments and at the county’s mental health crisis unit in southwest Santa Rosa.

County officials said they and Crestwood are searching for a site to open the mental health center by next fall. Officials said they have identified a potential property in Sebastopol, but would not say what or specifically where it is because talks are in the early stages. Sources said Tuesday one potential site is the old Fircrest Convalescent Hospital at 7025 Corline Court.

Bill Carter, director of the Sonoma County behavioral health division, said the shortage of psychiatric beds is a problem that affects communities across the country. Carter said beds in the new 16-bed regional mental health facility could be used to get people through the county’s crisis stabilization unit faster.

That in turn would relieve the bottleneck in local hospital emergency departments. Part of the problem is there aren’t many health care centers here to treat psychiatric patients and eligible to bill the federal government’s Medicaid program, which in California is known as Medi-Cal, for those between the ages of 19 and 64, Carter said.

The county’s new psychiatric health center would be eligible for federal matching money under Medi-Cal, he said.

County officials said the cost of operating 14 psychiatric beds (Marin County is going to pay for two of the beds in the planned mental health center) is estimated at $6 million a year - $3 million of which will be reimbursed by federal dollars.

The remaining cost will be funded through the county’s behavioral health programs.

In June 2018, the Sonoma County supervisors approved $500,000 in annual funding to support the operations of a new psychiatric center.

County officials said that because of the lack of mental health beds, patients often are kept at the crisis stabilization unit for several days, although the federal government only will pay for the first 23 hours of a patient’s treatment in the crisis center.

Tarek Salaway, senior vice president of Kaiser Permanente operations in Marin and Sonoma counties, said Kaiser’s contribution is aimed at hastening the opening of the psychiatric health center.

“Due to the fires, the need in our community for crisis intervention support is extreme,” Salaway said in an email. “This gift is the true definition of supporting the mental health of our entire community.”

Meanwhile, at Memorial hospital on Tuesday, Cheryl O’Brien, 56, lay on a gurney for several hours in the emergency department hallway. O’Brien has been going to the hospital’s emergency department every four months or so to be treated for a troublesome case of pancreatitis. This was not the first time she ha’s been treated in the hospital hallway because of overcrowding.

Gehri, the hospital’s director of emergency services, said Tuesday morning there were two psychiatric patients in the emergency department. She said a psychiatric patient who stays in the hospital for a day essentially takes up the bed space of eight patients who stay for three hours.

O’Brien, who said she used to be homeless and has spent time at the Sam Jones shelter in Santa Rosa, said a lot of people living on the streets are affected by the county’s lack of psychiatric treatment beds.

“There’s a lot of people out there who need help,” she said. “I know a lot of people at Sam Jones that need it, and out on the (Joe Rodota) trail that need it.”

Show Comment

Our Network

The Press Democrat
Sonoma Index-Tribune
North Bay Business Journal
Sonoma Magazine
Bite Club Eats
La Prensa Sonoma
Emerald Report
Spirited Magazine