Update: Updated to clarify that the behavioral health unit at Soldiers & Sailors Memorial Hospital provides services to adults only.
Should a non-profit, private health care provider be required to provide a service that it is not finding to be financially viable? How can a small rural community best care for the mental health needs of its residents — adult and children?
Those are two of the basic questions swirling around the community after news about Finger Lakes Health’s plans to close the Behavioral Health Unit at Soldiers & Sailors Memorial Hospital were revealed. An active community group, bolstered by school district and local government officials is asking even more.
While more current and former caregivers, clients, and family members are speaking out in opposition to the potential closure of the unit that serves adults, others say there is a serious lack of adequate mental health services for children. In both situations, people in education, law enforcement, and criminal justice fields say they are ill-equipped to help the growing number of people in dire need of mental health services.
Desperate School Staff
Dundee Central School Superintendent Kelly Houck says simply, “If they are not being treated from a clinical perspective, they are treated as criminals.”
Houck recently met with state and federal representatives after sending them a strongly-worded letter spelling out her concerns that the school’s resources are being exhausted. She does not shy away from painting a vividly desperate picture: “I fear what these children might do or who they might become if something significant is not done to change the current system,” she wrote to Assemblyman Phil Palmesano, Sen. Tom O’Mara, and U.S. Rep Tom Reed several days ago.
Her letter was spurred after school staff encountered what she calls unacceptable situations when three different students in crisis were taken to three different facilities within days. “All three were seen by clinical staff for 10 minutes or less (after waiting five plus hours to be seen) — no treatment, no medication prescribed, no admitting the child for further and complete evaluation/observation. Each family was told to follow up with their local provider and that the school needs to communicate the needs of the child on a greater level,” she wrote.
Since that meeting, Houck has been told that Yates County’s needs have become a priority for State Mental Health officials, and she understands a task force has been appointed by Commissioner Ann Marie Sullivan M.D.
Houck expects to learn more during a Feb. 26 follow-up conference call in which she has invited Penn Yan Superintendent Howard Dennis, Community Services Directors George Roets, from Yates County and Shawn Rosno, from Schuyler County to participate.
“I am urging, begging, pleading that this become a plight, a ticket/ballot/campaign item.... My students, my families, my community need something done. I do not want to become the next set of headlines,” she wrote. After the meeting, she promises to follow-up, saying, “This can’t be a conversation that ends here. I can’t let it go. I’ll be the thorn in their side.”
The County speaks
The Yates County Legislature is expected to make a statement about the possible closing of the hospital’s inpatient unit next week. A resolution opposing the planned closure will be introduced at the Feb. 11 Legislature meeting by Ed Bronson (District 2), who chairs the group’s Human Resources Committee.
Timothy Dennis (District 2) said the legislature is in charge of public health in the county, and mental health is part of public health. “I don’t think we should ignore the fact that we have a concern, and we have a responsibility,” he said, adding he’s not sure about interfering with a private, non-profit organization’s business. But Rick Willson (D2) said he feels Soldiers & Sailors function is to support the community, and it’s doing this is a failure to support the community.
None of the legislators indicated they would not support the resolution.
Yates County Sheriff Ron Spike has reported multiple times to legislators about the strain working with jail inmates that need mental health services puts on his staff.
A plan in limbo
The hospital’s plans, announced to staff in November but not officially articulated to the state until late January, could be in limbo, according to Roets.
He told legislators Monday he has learned the hospital needs authorization to close from the State’s Public Health and Health Planning Council, and the council isn’t scheduled to meet again until April.
Roets says he also understands that state officials have made unannounced visits to the hospital — some at night — to ensure the unit is still open.
He encouraged the legislators to send the message to state officials,”We’re the official body of Yates County. We’re concerned and we want you to live up to your obligations.”
Action has largely been spurred by a community group that has organized to oppose the potential closure of the unit that provides services to adults only.
Some employees say other workers began looking for jobs as soon as the November announcement was made. Now, with psychiatrists and trained psychiatric nurses leaving for other positions, hospital administrators may find themselves struggling to care for someone in need.
The community group of about 40 attended the first meeting, and another was planned for Feb. 5 at the Penn Yan Village Hall.
Lara Turbide, vice president community services at Finger Lakes Health, says no closure date has been set, and confirms there will not be a closure until approval is received from state officials.
According to a statement released by the community group last week, residents say they have observed a pattern of defunding at Soldiers & Sailors, cutting personnel and services well before the closure of the mental health inpatient unit was proposed. “Rather than closing down the mental health unit, the hospital should be investing more resources in the unit, so it can serve the community better,” one meeting attendee noted. “Mental Health services shouldn’t be about making a profit, they should be about keeping our community healthy and safe,” another resident continued.
Meeting attendees said the proposed closure would have wide-ranging impacts on the community, the hospital, and the quality of mental health care throughout the region. One former employee explained, “there is already a shortage of beds in Ontario, Yates, Schuyler, and Seneca Counties. Clifton Springs is the closest hospital with an inpatient unit and their beds are always full.” Healthcare providers explained that care could be compromised if mental health patients were far from their family, local resources, and follow-up care providers.
But Turbide says other facilities in the region are experiencing the same issues as Soldiers & Sailors: declining use, reduced reimbursements., and struggling to find psychiatry coverage for an inpatient program requiring coverage around the clock, 365 days per year. If the unit here closes, the others might be able to operate with more consistent staffing and finances.
Current and former mental health care professionals at the meeting expressed concerns about the massive burden the proposed unit closure will have on the emergency department, which is not equipped to provide mental health treatment.
According to the statement, community members vow to keep fighting for community healthcare, and they are asking that the New York Department of Health “conduct a community impact study on the possible closure of the inpatient mental health unit.” They are encouraging others concerned about the unit closure to submit public comments to the New York Department of Health: email@example.com.
At the same time, Houck will stay in touch with state officials to advocate for the children she and her staff work with every day.