MNA is in the news again, this time in a powerful front-page story in the Cambridge Chronicle about our opposition to the announcement by Cambridge Health Alliance of their intent to close 11 beds for the care of young children with serious psychiatric illnesses. We will be fighting this decision and mobilizing advocates and concerned residents to attend a DPH Public Hearing on this closing whenever it is scheduled. This announcement comes at a time of critical shortage for all types of beds and services for the mentally ill, particularly children, while more than 40,000 patients a year are boarding in our emergency departments for days and sometimes weeks waiting for care.
Cambridge Health Alliance to reduce child psychiatric care
CAMBRIDGE, MA – The Cambridge Health Alliance (CHA) is eliminating 11 of its 27 inpatient beds for child psychiatric care and ceasing service for children under the age of eight, representatives from the hospital announced April 3. The Massachusetts Nurses Association, along with the Massachusetts chapter of the National Association for the Mentally Ill, have both decried the decision.
Every day, CHA nurse Kerry McCalister sees children in a state of crisis. Some are suicidal or homicidal, some are experiencing auditory or visual hallucinations, some are so aggressive they can’t make it through a school day.
“These are the sickest children in the state,” McCalister said. “From an advocacy point of view, it’s very concerning because this is a time when children and families need more access, and this looks like cuts in services and less access.”
From 2004-2010, the state lost 65 beds for children and adolescents, an 18 percent decrease in total beds across Massachusetts, according to Department of Mental Health Licensing Director Lizbeth Kinkead. The loss of CHA’s 11 beds represents a 26 percent decrease in beds across the commonwealth.
“We are devastated by this cut,” said Laurie Martinelli, executive director of Massachusetts chapter of the National Association of the Mentally Ill. “There is a crisis in the state about the lack of psychiatric beds already, particularly child beds. The CHA has been a leader in child psychology, so we are just devastated by this loss.”
CHA spokesman David Cecere said 20 percent of the patients in CHA’s Child Assessment Unit are less than eight years old, or just eight percent of the hospital’s child and adolescent patients combined. The decision to combine the two units was mostly financial, Cecere said.
“We take great pride in offering behavioral health services to a significant spectrum of ages, but the payments we receive from all payers for these services are inadequate,” Cecere said in a statement. “We believe an integrated unit will allow us to provide excellent care to the largest number of patients within the constraints of our limited resources.”
Cecere also said the trend falls in line with the state’s strategy to shift behavioral health care to outpatient, community settings close to where patients live. In addition to the inpatient services, Cecere said the CHA offers outpatient psychiatric care, including a Child Ambulatory Service, providing evaluation and treatment to teenagers, integrated behavioral health service at primary care practices, and mental health services at school-based health centers, including Cambridge Rindge and Latin School.
“Integrating the units is a function of our efforts to evaluate how we can best serve our patients in a rapidly changing environment marked by declining reimbursements, funding cuts, and payment reform,” said Cecere. “These challenges are amplified for us in our role as a safety net provider. We want to be sure we provide the optimum mix of services, in the right setting, with right staffing, and at the right capacity to operate as efficiently as possible while meeting the needs of our patients and communities.”
A representative from the Department of Mental Health did not immediately return a request for comment about statewide trends, but said the state would be reviewing the decision and holding a public hearing it represents a change in “essential services.”
This year, the state Legislature convened a Mental Health Commission, which is tasked with reviewing shortages in all types of mental health services and beds.
“The Department of Public Health will work closely with the Cambridge Health Alliance and with other area providers to ensure that any plan includes the appropriate continuity of care for patients in the area,” the statement read.
Area options for inpatient care for children under the age of eight include the Franciscan Hospital for Children in Brighton, the Westwood Lodge operated by the Arbour Health System, MetroWest Medical Center in Natick, and the North Shore Medical Center’s Union Hospital in Lynn. The Boston Children’s Hospital also provides inpatient care for children aged 8-18.
In the wake of the Sandy Hook shooting in Newtown, Conn., that took the lives of 26 people, Massachusetts Nurses Alliance spokesman David Schildmeier said it was more critical than ever to double down on mental health services, not cut back.
“We look at Sandy Hook and yes, the major focus was on gun control, but the second biggest argument was how can we prevent this?” Schildmeier said. “The kids who don’t get treated, they’re the next Sandy Hook assassin. We need to prevent that. We can treat mental illness and manage it so that people don’t have to be violent, if we identify it early on.”
A date for the public hearing had not been scheduled at the time of this writing.
Contact Cambridge Chronicle assistant editor Erin Baldassari at ebaldassari@wickedlocal.com or 617-629-3390, and follow her on Twitter: @e_baldi.
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