The Proposal Comes at a Time When Mental Health Advocates Cite a Critical Shortage of Behavioral Health Beds and Services and When 40,000 Patients a Year are Being Boarded in Mass. Hospital Emergency Departments for Days and Even Weeks Waiting for Care
The Closing of Taunton Will be Devastating for Patients in the Southeast Region Where ED Overcrowding is the Highest and Where Utilization of
TAUNTON, MA – At a time when mental health advocates across the state and across the nation are decrying a dramatic shortage of psychiatric beds and services for the care of the mentally ill and when more than 40,000 patients with mental illness are being boarded without proper care in our state’s hospital emergency departments waiting for these beds, the Governor has released a budget today that once again calls for the closure of the remaining 45 beds at Taunton State Hospital.
The loss of Taunton State Hospital will have a devastating impact on patients in the Southeast Region where ED overcrowding is among the highest in the state, and where utilization of mental health services is also the highest in the state, according to data gathered by a special Mental Health Advisory Committee, a body of advocates, mental health providers and legislators established by the legislature in 2012 in response to the growing mental health crisis in Massachusetts, and in response to the Governor’s previous attempt to close Taunton State Hospital.
“We are shocked at what can only be described as the Governor’s abandonment of responsibility for the care of the mentally ill in Massachusetts,” said Karen Coughlin, a nurse at Taunton State Hospital, vice president of the Massachusetts Nurses Association/National Nurses United and a member of the state’s Mental Health Advisory Committee. “We have no mental health care safety net in Massachusetts. There are not, and have not been, enough beds or services in the system for years. This decision will only exacerbate a long standing crisis, where every emergency department in the state is overcrowded with psychiatric patients waiting for days and even weeks for care. People will continue to go without care, crime will increase, homelessness will increase, more people will end up in the corrections system and many more will commit suicide.”
Taunton State Hospital is one of only six state operated mental health facilities in the state to care for people suffering from acute and chronic mental illness, including providing care to some of the most challenging clients with a history of sexual assault and violence. Despite these challenges, the staff and programs at Taunton State Hospital have garnered state and national attention for the quality of care it delivers. The facility has received a national award for its low level of restraint use for its patients, and last August, Taunton State Hospital was the first DMH facility to ever record a full month without the use of a patient restraint. In 2010, a study of patients discharged from Taunton State showed a mere 6 percent readmission rate, which is well below what is expected for this type of facility.
If the closing goes forward, clients and families will be expected to travel 50 to 100 miles for care in Worcester or Tewksbury at facilities that are already over burdened. In addition the closure comes at a time when the state has lost more than 200 mental health inpatient beds, going from 834 beds in 2010 to the current total of 626 beds, also coming at a time when the state has slashed its mental health care spending more than any state in New England.
The Governor’s Misguided Plan
The Governor’s plan to close Taunton State Hospital will be unveiled this week with the release of his budget. It calls for closing the remaining 45 beds at Taunton State Hospital (the administration closed 124 beds at Taunton in 2013), and transferring those patients to the Worcester Recovery Center. The administration plan contemplates utilizing the estimated $6 million saved with the closing to reinvest in new services for the mentally ill in the Southeast Region.
It is important to note that while hospital emergency departments have been swamped with patients, including hospital emergency departments in Worcester-area hospitals, the DMH and the administration has purposefully kept beds closed at the Worcester Recovery Center for over a year, allowing Worcester area patients to languish without care in local emergency departments so that Worcester Recovery Center beds would be available under the Governor’s new plan, to take in patients from Taunton State Hospital.
“Their plan makes no sense and their decision to withhold needed beds for patients in need is unconscionable,” Coughlin said. “Our system has been operating well over full capacity for years. We can’t provide the care people need even with our facility open. It’s a travesty.”
The DMH claim that 626 beds are adequate for the care of those with mental illness has no objective or therapeutic underpinning. The allotment of beds, both in number and geography is based entirely on the DMH’s attempt to provide services based on limited funding driven by political not clinical decisions. The planned transfer of patients out of the Southeast Region to Worcester also goes against the administration’s goal of ensuring that patients with mental illness receive care in their own community.
“The reality is they should have never closed beds at Taunton State in 2013 and they certainly should not close the remaining beds,” Coughlin stated. “The MNA, along with local legislators have proposed opening up beds at Taunton State Hospital with new admissions criteria to allow for the treatment of patients currently being boarded in our emergency departments, as well as beds to handle forensic patients who are involved in the corrections system. We need more beds not less, and we need the additional services the Governor has proposed, but those should be in addition to the services that currently exist.”
In southeastern Mass, opposition to previous attempts to close Taunton State Hospital has been vocal and widespread, and includes opposition from city and town councils from communities throughout the region, local law enforcement officials, religious leaders and the Southeast and Cape Chapters of the Alliance for the Mentally Ill in Massachusetts. State Representative Patricia Haddad, who has Taunton State Hospital in her district, was among those opposing the closing and now serves as the co-chair of the Mental Health Advisory Committee.
The opposition to the closing is justified by data gathered by the Mental Health Advisory Committee last year, including:
- Taunton State Hospital, as well as the other state operated facilities, has taken on the most complex and difficult to manage patients in the entire system.
- All types of facilities in both the public and private sector are already at 80 – 95 percent capacity, and in 2012, TSH had the second highest number of admissions of all state facilities.
- Other facilities in the region, including Pocasset and Corrigan Mental Health Centers, are also at 90 percent capacity, and many of their patients are there for several weeks and months, making those patients defacto continuing care patients that could and should be admitted to TSH, yet now they cannot be admitted.
- Emergency departments in the Southeast region experience excessive boarding of patients with mental illness, and in one case, a patient at Morton Hospital in Taunton, waited several months for a psychiatric bed to open, being housed with little or no care on the hospital’s medical surgical floor, until finally being placed at a facility in New Hampshire.
The MNA/NNU, which represents 45 RNs and health professionals who work at Taunton State Hospital, more than 1,800 staff who work throughout the state system, and more than 1,500 nurses working in the emergency departments and psychiatric units of 51 private sector acute care hospitals are committed to working with policy makers and elected officials to ensure that Massachusetts, which used to be a leader in the provision of mental health care, maintains its commitment to the most vulnerable residents of the Commonwealth.
“This has gone beyond an issue of funding and finances,” Coughlin concluded. “This is a moral and ethical issue of human rights and common decency.”
Founded in 1903, the Massachusetts Nurses Association/National Nurses United is the largest professional health care organization and the largest union of registered nurses in the Commonwealth of Massachusetts. Its 23,000 members advance the nursing profession by fostering high standards of nursing practice, promoting the economic and general welfare of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Legislature and regulatory agencies on health care issues affecting nurses and the public. The MNA is a founding member of National Nurses United, the largest national nurses union in the United States with more than 170,000 members from coast to coast.
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