Mental health patients strain hospital ERsBy Jill Coley (Contact)
The Post and Courier
Sunday, November 23, 2008
Melissa Haneline Talvin Williamson, an emergency room technician at Trident Medical Center, monitors the behavior of four mental health patients by camera every 15 minutes. By the numbersMental health patients in S.C. emergency departments: Year Visits* Patients** 1998 33,538 26,718 2002 39,553 30,782 2007 47,509 36,330 *Number of visits to South Carolina emergency departments in which the primary diagnosis was mental illness and/or alcohol and drugs. **The number of patients responsible for the visits. Six mental health patients spent Labor Day weekend in Trident Medical Center's emergency department. As hospital staff struggled to funnel the patients into an overloaded and shrinking mental health care network, they filled nearly half of the department's rooms. According to Trident's protocol, four camera-equipped rooms are filled first, with a staff member constantly watching patients on a monitor nearby. Each patient beyond the fourth requires a sitter, and when a sixth patient arrives, a security guard must also stand duty. Mental health patients are backing up in emergency departments across the state, some waiting days or weeks for psychiatric beds to open or to transition into outpatient facilities. "We've always held patients at some point but not to the extent we do now," said Mindi Huckabee, the hospital's director of emergency services. "In the past two to three years, it gets worse and worse and worse." State budget cuts are eating away at an already strained mental health care system. And more cuts are on the way. Compound that scenario with the holiday season and the economic crisis, Huckabee said, and "Patients who have never had an issue are going to have problems with depression and suicidal thoughts." Last holiday season, a suicidal patient stayed in the Trident emergency department for 28 days, she said. In the 1980s, mental health hospitals started shutting down across the country, in favor of community based, outpatient care. The sentiment in the psychiatric community was that a lot of patients who were warehoused could be more humanely managed in residential settings. In South Carolina, community residential care facilities house about 16,000 people who need daily assistance, ranging from managing multiple chronic diseases to daily reminders to take their medication. These operations are funded by a mishmash of sources, including state appropriations and the S.C. Department of Mental Health — both diminishing under falling state revenue. The facilities can be nonprofit or for-profit, family or corporate owned, and range in size from three beds to more than 100. As the role of psychiatric hospitals faded, community residential care facilities and outpatient counseling were supposed to rise and replace them, but years of budget cuts, ending with this year's coup de grace, have left many patients, literally, with nowhere to go. More cuts State budget cuts this fall have reduced the Department of Mental Health's budget by $26 million, or about 13 percent, said Mark Binkley, general counsel for the department. The Legislature is likely to cut another 2 percent in December, and more cuts may follow when legislators convene next year. These recent slices come after a long, slow strangle. The department of mental health has 501 fewer beds than in 2000, including hospital and community residential care facilities. In addition, private hospitals have slashed psychiatric and rehabilitation beds over the last decade. The Institute of Psychiatry and Palmetto Behavioral Health are the only two area hospitals that provide inpatient acute psychiatric care, and both are nearly always full. Dr. Sue Hardesty, medical directory for the institute, said, "We currently have 81 active beds and are staying nearly full. We have decreased by about 14 beds from our max of two years ago." More than 15 percent of services provided at the institute go to uninsured or Medicaid patients. Hardesty said, "As a result, MUSC has had to re-assess our ability to serve certain populations that have traditionally sought care here." Palmetto Behavioral Health, which has 80 acute hospital beds and 32 long-term residential treatment beds, does not accept Medicaid, a hospital spokeswoman said. Matt Dorman directs the TriCounty Crisis Stabilization Center, a 10-bed unit that is part of the Charleston Dorchester Mental Health Center, and under the umbrella of the state department of mental health. The bulk of the center's patients come from area emergency departments, which contribute financially to the center. Of the 681 patients the center treated last year, more than half were uninsured. The center stabilizes patients who do not need to be hospitalized, yet do need intervention for a few days before returning to outpatient care. As resources shrink, demand rises. The number of emergency room discharges with a primary diagnosis of mental disorder in Berkeley, Charleston and Dorchester counties rose 14.5 percent between 2002 and 2006, topping out at 7,649 visits, according to the S.C. Office of Research and Statistics. Breaking point Last year at Moncks Corner Medical Center's emergency department, a mental health patient punched a nurse. In another incident at the same location, a patient ran through the ER, burst into another patient's room, hitting them with the door before they could be restrained. Moncks Corner doesn't have a cafeteria on site, so staff must walk to the Piggly Wiggly down the road to buy food for mental health patients who stay overnight. Some patients in crisis are violent, others remove their clothing — behavior that can intimidate medical patients in the same space. Jim Walker, senior vice president with the S.C. Hospital Association, said, "The emergency department is not set up to house and provide longer term treatment. Most hospitals don't have psychiatrists on staff to manage care." Emergency room directors are flummoxed. "Placement is extremely difficult. It's getting harder on a monthly basis," said Wanda Brockmeyer, service line director for Roper St. Francis Emergency Services. Lynn, who did not want to release her full name, ended up in two area emergency rooms this year with her husband, seeking help for his crack cocaine addiction. After eight years of sobriety, Lynn's husband suddenly relapsed. He disappeared for days then called home, afraid he had overdosed. She drove him to an emergency room, but he could not be admitted because alcohol was not involved, she said. For two weeks, they went to outpatient facilities, once getting him admitted to an inpatient hospital before he backed out at the last minute. A Valentine's Day suicide attempt by overdosing on his bipolar medication led Lynn's husband to Trident's emergency department. In less than a day, he was admitted to Palmettto Behavioral Health, Lynn said. "It's a long roundabout process and a shame you have to go through that," Lynn said. Her husband is doing better and working hard on his recovery, she said. Quarterly, a group of about 30 area stakeholders meets to brainstorm solutions to the crisis. Hospital personnel, law enforcement and representatives from the psychiatric community gather. One idea floated is the creation of a psychiatric emergency department, but that is years away. In the meantime, the safety net will continue to unravel. "It is going to be worse," Walker said. "And there could be a serious situation as a result." Reach Jill Coley at 937-5719 or jcoley@postandcourier.com. |
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This article has 32 comment(s)
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Posted by pirate42 on November 23, 2008 at 5:05 a.m. (Suggest removal)
lets send them all to governor sanford home for christmas heard his place on sullivans Island has plenty of bedrooms
Posted by rusted1 on November 23, 2008 at 6:56 a.m. (Suggest removal)
Now to make these matters worse Charleston Memorial Hospital Emergency Dept is closing it's doors on 11/24/08. Many,many, many area Mental Health Clients had been going to CMH ED for years for much of their crisis management. Now where will they go?
Posted by sfarris on November 23, 2008 at 7:15 a.m. (Suggest removal)
This is scary, when a person is mentally ill and a danger to self and others...what does society do? Tell them to get help, then shut the doors. Today more than ever we should be aware of this as a disease, as something that is not a sign of weakness, but a reason to get help.
There are FREE national suicide hotlines, and calling one to talk can make all the difference.
Posted by karmann on November 23, 2008 at 7:28 a.m. (Suggest removal)
Every government agency operates, to some degree or for the most part, on taxes. Is anyone willing to have their taxes raised to pay for needed services? When agencies operate on "projected" billing and revenues, and those two sources of income fall short, then agencies suffer and have been this way for many years. The State government and local agencies need to stop or at least not depend so heavily on "projected" revenues. Then maybe we would not have this cycle of financial problems. How many private households budget according to "projected" finances vs actual known income?
Posted by 2cents on November 23, 2008 at 7:30 a.m. (Suggest removal)
Most hospitals don't have psychiatrists on staff to manage care."
What???? People admitted with medical problems may also have mental health problems. Who is taking care of them????
Posted by B_Fwank on November 23, 2008 at 8:10 a.m. (Suggest removal)
You can thank the ACLU for this problem. One of the big ACLU and liberal lawyer triumphs of the 1960s (and one they're still working on at irregular intervals today) was to deinstitutionalize the mentally ill.
The ACLU stated the mentaly ill could not be held against their will if they had not committed a crime. It violated their civil rights.
And they continue to fight to keep them on the srteets.
http://patterico.com/2007/10/11/aclu-win...
http://www.claytoncramer.com/speeches/me...
Posted by B_Fwank on November 23, 2008 at 8:36 a.m. (Suggest removal)
Of, course, this article would explain why people like johnq, aka, spankerbuns, aka, JimIslander, continue to need serious mental help but are not getting it.
Posted by B_Fwank on November 23, 2008 at 8:57 a.m. (Suggest removal)
Get help spanky, your going to blow a gasket. Before the ACLU, mental patients did get help and were treated, before being released. Its easy to blame the health care industry, when you need to demonize that industry with the goal of destroying it so you and the leftists like you can hope for universal care (free). LOL, Universal health care is a failed idea of the left, it can not sustain itself.
But hey, maybe if it works for about 7 months, you can get those meds you so desperatly need.
Posted by exorcist_pencocky4u on November 23, 2008 at 9:02 a.m. (Suggest removal)
Ok, so JimIslander is a Liberal, Socialist, democrat that longs for the day that his Comrades in Washington can "DESTROY" the American Health Care System and replace it with a system that allows people like him to decide who does and who doesn't get treatment.
Thats no reason not to love him like a brother.
Posted by B_Fwank on November 23, 2008 at 9:02 a.m. (Suggest removal)
And what is it with you and boot licking?
Hawaii ends universal health care for kids
HONOLULU, Hawaii (AP) -- Hawaii is dropping the only state universal child health care program in the country just seven months after it launched.
Gov. Linda Lingle's administration cited budget shortfalls and other available health care options for eliminating funding for the program. A state official said families were dropping private coverage so their children would be eligible for the subsidized plan.
"People who were already able to afford health care began to stop paying for it so they could get it for free," said Dr. Kenny Fink, the administrator for Med-QUEST at the Department of Human Services. "I don't believe that was the intent of the program."
http://www.cnn.com/2008/HEALTH/10/17/haw...
"People who were already able to afford health care began to stop paying for it so they could get it for free," said Dr. Kenny Fink, - and why not, it is their tax dollars paying for it? Why pay for it twice? Should they be discriminated against because they can "afford" it? Typical Animal Farm; Orwellian, leftist, thought!
You see, that is the crux of the problem, some one has to pay, higher taxes, higher prices on a comppanies product to support those taxes, higher wages for employees to by higher priced products....
Utopia does not exist.
Posted by B_Fwank on November 23, 2008 at 9:10 a.m. (Suggest removal)
Posted by JimIslander on November 23, 2008 at 8:52 a.m.
"Trident and those like them would prefer these people to just die rather than help them."
You are the one that is disgusting and deluded.
In fact, your strange and deluded ramblings seem to be of a rather odd and bitter person.
Posted by moonpie on November 23, 2008 at 9:19 a.m. (Suggest removal)
B FWANK, THAT WAS EXACTLY WHAT I WAS THINKING. BUT YOU FORGOT "ZOOMRU"....NOW THERE'S A GASKET ABOUT TO BURST!
Good luck spankerass, jimislander,johnq! Don't worry our president elect will fix this too! I'm sure he mentioned it in his election all about "change". Looks like he's a little off cue with these cabinet picks or was that what he promised the Clintons??
This is a sad story and will only get worse apparently. Oh yeah JI your forgot to mention that hospitals also have to take care of all the illegals that wander in the hospital er's too that can't pay.
"Utopia does not exist", best quote I read all day!
Posted by B_Fwank on November 23, 2008 at 9:23 a.m. (Suggest removal)
LOL, moonpie, ZOOMRU has blown that gasket!
Great point too moonpie - you forgot to mention that hospitals also have to take care of all the illegals that wander into the hospital."
You have to love bleeding heart liberals, everytime they fix something with false compassion, pie in the sky ideals, and feel good programs - they just make it worse.
Posted by jamie29456 on November 23, 2008 at 9:45 a.m. (Suggest removal)
The mental health network has proven to be dwindling in a recent experience trying to get help for my delusional daughter. One would think that MUSC would have something to offer but all I heard was $160.00 an hour. For people with no insurance, no help has been the answer. Patients need medicine and professionals to talk to but no insurance closes doors! What is left in Charleston county?
Posted by exorcist_pencocky4u on November 23, 2008 at 9:49 a.m. (Suggest removal)
Oh, wow JimIslander, so much hate and negative waves this early on a gorgeous Sunday morning.
You are insulting good, decent, God fearing black men and women everywhere. President "0" has shown his true colors with his administration picks. He has indicated all intent to govern from his "WHITE" side and further enslave the Brothers and Sisters.
Posted by exorcist_pencocky4u on November 23, 2008 at 9:58 a.m. (Suggest removal)
JimIslander - You need to get dressed and go outside, do something vigorous like taking a nice walk or raking leaves and just soak up this gorgeous day that "GOD" has made us. There will be no charge for this mental health advice.
Posted by exorcist_pencocky4u on November 23, 2008 at 10:11 a.m. (Suggest removal)
JimIslander - what you need to understand is that in every country, where this Liberal, Socialist government run, free health care experiment has been tried, it has fallen flat and denied important health care to those that need it the most.
While at the same time taxes have been pressed astronomically higher, waiting lines have grown astronomically longer. In many countries the price per gallon of gas contains 60%-70% tax. Tobacco, Beer, Wine, and Liquor is heavily taxed.
Posted by exorcist_pencocky4u on November 23, 2008 at 10:14 a.m. (Suggest removal)
Oh, talking about mental health, where is your alter ego GuidedbyStuart today?
Posted by exorcist_pencocky4u on November 23, 2008 at 10:32 a.m. (Suggest removal)
We are already paying young girls loads of money to have lots of children.
Maybe its time to stop this madness and divert the money to mental health.
Posted by native_azzholla on November 23, 2008 at 10:43 a.m. (Suggest removal)
Are you bored exorcist_pencocky4u and just looking for an argument?
Maybe it is you who needs "to get dressed and go outside, do something vigorous like taking a nice walk or raking leaves and just soak up this gorgeous day that "GOD" has made us."
I'll see ya outside, try to have yourself a nice day.
This session is over and there will be no charge today.
Posted by exorcist_pencocky4u on November 23, 2008 at 10:54 a.m. (Suggest removal)
Posted by native_azzholla on November 23, 2008 at 10:43 a.m. (Suggest removal)
Are you bored exorcist_pencocky4u and just looking for an argument?
Maybe it is you who needs "to get dressed and go outside, do something vigorous like taking a nice walk or raking leaves and just soak up this gorgeous day that "GOD" has made us."
I'll see ya outside, try to have yourself a nice day.
This session is over and there will be no charge today.
▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒
I've been outside enjoying this gorgeous day of "GOD"s creation for the past couple of hours, glad you could finally get out into it. Remember to do some vigorous exercise, it should loosen up your heart and get some of the hate out.
Call back anytime you need some advice. Its good to help.
Posted by geekboy on November 23, 2008 at 11:41 a.m. (Suggest removal)
It's a damn shame this crisis is hitting now, because JimIslander/Spankerbuns/LiberalTime is definitely in need of some treatment.
Posted by ColdBud on November 23, 2008 at 12:04 p.m. (Suggest removal)
I'm just surprised to see that we have so many that still read JimIslander's post... why not just skip over them? It's not like he adds anything intelligent to any of the threads. I never read anything he types. I will admit though... he's not the only poster that I skip over. I enjoy reading differing opinions... when they are presented in an intelligent manner. We have some like JimIslander, and a few others, that never offer anything but hate and discontent. They're called internet trolls. Posting simply to get people riled up. Just skip over the posts they make and they die a slow, lonely death.
Metal health issues are tricky. If someone's mental health is such that they can be dangerous to others, they should not be part of society. That raises the question of who should take care of them, how they will be taken care of and who foots the bill. As someone already mentioned... it'll take tax payer dollars no matter which way it goes.
Posted by johnnyholmes on November 23, 2008 at 12:13 p.m. (Suggest removal)
Jim, Spanker, Johnq....whatever,
Please pretty please comment on Mr. O'Bama and the little MRS. electing to send their kids to Sidewell Friends School in D.C. thus saying the little black kids in public schools aren't good enough to be classmates of Malia and Sasha. Kindly remember Jim one of Mr. O'Bama's first intentions is to put unemployed workers to work "modernizing public schools". You have dodged me b-4 on this question, why not answer it now? BTW the article I referred to is in the New York Daily News this date.
Posted by guidedbystewart on November 23, 2008 at 2:18 p.m. (Suggest removal)
"We have some like JimIslander, and a few others, that never offer anything but hate and discontent. They're called internet trolls. Posting simply to get people riled up. Just skip over the posts they make and they die a slow, lonely death."
Posted by exorcist_pencocky4u on November 23, 2008 at 10:14 a.m. (Suggest removal)
"talking about mental health, where is your alter ego GuidedbyStuart today?"
exorcist_pencocky4u anyone.....
Anyhoo, it is not any secret that the healthcare in this State is abysmal for the mentally ill. The problem is too few people care unless it is a member of their own family that is mentally ill. It is definitely a sad state of affairs knowing what a person with mental illness has to go through to get proper care in this State.
Posted by exorcist_pencocky4u on November 23, 2008 at 3:56 p.m. (Suggest removal)
You can leave anytime you want JimIslander, I'm not keeping you here in the backward Tri-County Metro Area. You would probably be happier in Ohio or New York.
Posted by B_Fwank on November 23, 2008 at 4:14 p.m. (Suggest removal)
JimISpankyQ, LOL, you are a nut job. So retirees dont deserve what they have worked for? I take it you include the parasites that have embedded themselves in the UAW?
You are a babbling, typing loone! No body is even talking about Obamas race, you have a very sick and twisted mind to continue to think that we will be RULED by a black man.
He will be the President, along with congress and our constitution, he will rule nothing. Not to mention that he has quickly become a hand puppet for the Clintonistas, so much for change.
And if he cant accomplish all that he promised, he will be voted out in 2012, same with the democrats in 2010.
You are nothing but a race baiting, hate filled, bitter little boy. Pathetic. Coldbud, is right, no one should respond to you, but your deluded rants need responce at times.
The only ones that are going to get what is coming to them, is societies leeches that will show up at Obama's coronation, with their collective hands out. And what is coming to them is unfulfilled promises by yet another democrat, who use them every year to get votes.
Liberalism is indeed a mental disorder!
Liberals clinically mad, concludes top psychiatrist
Eminent doctor makes case leftist ideology is a mental disorder
"Based on strikingly irrational beliefs and emotions, modern liberals relentlessly undermine the most important principles on which our freedoms were founded," says Dr. Lyle Rossiter, author of the new book, "The Liberal Mind: The Psychological Causes of Political Madness." "Like spoiled, angry children, they rebel against the normal responsibilities of adulthood and demand that a parental government meet their needs from cradle to grave."
http://worldnetdaily.com/index.php?fa=PA...
Posted by B_Fwank on November 23, 2008 at 4:32 p.m. (Suggest removal)
Dr. Rossiter says the liberal agenda preys on weakness and feelings of inferiority in the population by:
creating and reinforcing perceptions of victimization;
satisfying infantile claims to entitlement, indulgence and compensation;
augmenting primitive feelings of envy;
rejecting the sovereignty of the individual, subordinating him to the will of the government.
"The roots of liberalism – and its associated madness – can be clearly identified by understanding how children develop from infancy to adulthood and how distorted development produces the irrational beliefs of the liberal mind," he says. "When the modern liberal mind whines about imaginary victims, rages against imaginary villains and seeks above all else to run the lives of persons competent to run their own lives, the neurosis of the liberal mind becomes painfully obvious."
http://worldnetdaily.com/index.php?fa=PA...
Posted by yird on November 23, 2008 at 5:37 p.m. (Suggest removal)
Hey Jim I Slander everyone, there coming to take you a way.
It's okay Jimmy Boy, they'll let you keep your Barbi dolls
Posted by 2dogs1bear on November 23, 2008 at 6:52 p.m. (Suggest removal)
FBI statistic show that 1/2 the prison population is mentally ill. We emptied the mental hospitals and this is the result. Often they attempt to self-medicate with street drugs and are then incarcerated for drug crimes. We could see a dramatic decrease in the prison population if we provided adequate services for the mentally ill. Prison is no place for these people. They need treatment. BTW mentally ill people are more likely to be the victims of violet crime than perpetrators.
Posted by majorjohnson on November 23, 2008 at 8:20 p.m. (Suggest removal)
lol...you think it's bad now with the bit of "free" health care we have, wait till it's free to all of us. there won't be any health care, and our taxes will be so high we can't afford to eat either.
The real deal about these socialists is that if they can spread the wealth they will, but if all they can do is spread the misery that's just as good. As long as everyone is equally miserable they think that's ideal.
Posted by abitskeptical on November 23, 2008 at 9:03 p.m. (Suggest removal)
Mental illness occurs in many forms & ranges of severity & almost always requires treatment. Treating mental illness benefits the individual as well as society as a whole.
There are many functional successful &/or professional &/or creative people under treatment for various mental illnesses. They are functional because they received proper treatment either before or soon after a crisis episode which often is the first definitive "sign" (to them) that something is wrong. In receiving proper treatment for this disease process these people have continued to function & contribute to their families, professions & society.
Like many disease processes that go untreated, mental illness usually progresses in severity, the longer it goes untreated. Without treatment, the individual gets into a viscous cyclone of pathology (thinking which affects behavior) that starts spins faster & faster. The brain chemistry gets so off that stabilization often requires a hospitalization which likely would not have been necessary had intervention occurred earlier in the process.
I don't know what the answer is, but it always amazes me that mental illness, which affects the control center (the brain) of human function is treated as if it should be an "elective" medical issue. People w/ untreated mental illness also have a higher rate of other medical problems.