BOSTON, Mass. – Legislation drafted by registered nurses on the front lines of the state’s behavioral health crisis have received favorable reports from the Joint Committee on Mental Health, Substance Use and Recovery, moving forward solutions aimed at specific challenges while at the same time momentum on Beacon Hill appears to have shifted toward making substantial mental health care improvements to support patients and families.
Nurse-backed legislation is advancing as Gov. Charlie Baker is advocating for a 30% increase in investment in primary and behavioral healthcare and Senate President Karen Spilka has introduced a bill to improve mental health parity by requiring any hospital with an emergency department to “have the capacity to evaluate and stabilize a person admitted with a mental health presentation at all times,” among other provisions.
“Ensuring our patients and their families receive the kind of high-quality and safe mental health care they need to successfully recover is a responsibility we must fulfill,” said Donna Kelly Williams, RN and President of the Massachusetts Nurses Association. “We know patients in acute crisis need specialized treatment programs, and that our emergency departments are overflowing with patients who deserve better care. Our legislation will help solve these problems and we look forward to our elected officials comprehensively tackling our state’s behavioral health crisis.”
At the same time elected officials are signaling investment in mental health, hospital executives are eliminating or proposing to close essential services. Baystate Health has proposed shuttering inpatient mental health services in Greenfield, Westfield and Palmer, and Tenet Healthcare recently said it would close its specialized psychiatric unit within the system’s Natick emergency department as part of a larger elimination of inpatient services.
The two MNA mental health bills that have advanced favorably are:
- An Act Relative to Creating Intensive Stabilization and Treatment Units within the Department of Mental Health (S. 1163/H. 1719), sponsored by Sen. Marc Pacheco, D-Taunton and Rep. Patricia Haddad, D-Somerset, creates male and female Intensive Stabilization and Treatment units within the state Department of Mental Health. Patients exhibiting extreme aggression, highly assaultive behavior and/or self-destructive behavior would be admitted to a specialized unit. These units would be highly secure, physically separate, structured environments with specially trained staff.
Healthcare professionals, patients and families are experiencing increasingly dangerous conditions at facilities like Worcester Recovery Center and Hospital, where a WCVB Channel 5 investigation last year revealed patient deaths, illicit drugs and alarming rates of assaults. The reports paint a grim picture of the conditions at WRCH, including patient overdoses, physical and sexual assaults, and hundreds of injuries to staff. As of May 2019, there had been at least 381 assaults reported at the facility, according to MNA records. State records obtained by WCVB showed 96 assaults with injuries requiring medical attention over the past three years.
“As healthcare professionals on the front lines, we see the danger posed to our patients, co-workers, and ourselves by individuals who may become violent and we must take proactive steps to address these dangers,” said Karen Coughlin RN, member of the MNA Board of Directors and former longtime Department of Mental Health RN. “While we believe individuals with severe behavioral health needs deserve the best care possible, the fact remains that there are patients who, despite the best efforts of treatment, pose a risk due to violent behaviors. These units will be designed and staffed to provide the level of care and attention to this complex population requires to ensure their safety and the safety of staff providing care.”
- An Act Relative to Creating a Pilot Program to Transfer High Acuity Behavioral Health and Dual Diagnosis Patients Away from Crowded Emergency Departments (S. 1164/H. 1720), sponsored by Sen. Marc Pacheco, D-Taunton, and Rep. Patricia Haddad, D-Somerset, creates a pilot program at Taunton State Hospital to transfer medically stable, high acuity behavioral health and dual diagnosis patients away from overcrowded emergency departments until such time that an appropriate placement is found to meet the patient's needs.
For years, an influx of behavioral health patients into Massachusetts emergency departments has been clashing against an ED system in which patients are already waiting too long for care. A study conducted by the Mass. legislature’s Mental Health Advisory Commission found that as many as 40,000 patients a year are boarding in our state’s hospital emergency departments, waiting for hours or even several days for appropriate beds and services.
Research by registered nurse and Boston College associate professor Judith Shindul-Rothschild also demonstrates the existing ED wait-time problem in Massachusetts hospitals. For example, her research showed that patients at UMass Marlborough Hospital on average waited more than two hours to be evaluated in the ED.
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