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Hospital shifts plans for mental health care

News-Topic - 3/6/2018

March 06--Caldwell Memorial Hospital has scrapped plans to renovate its fifth floor into a psychiatric unit, choosing instead to build a separate facility with a more expansive mental health mission, hospital officials said.

The building that currently houses the Caldwell Memorial Hospital Foundation will be demolished in a few months to make way for it.

The behavorial health pavilion will include a 28-bed inpatient unit, an outpatient clinic and a resource center for families to learn about mental health and illnesses, said Laura Easton, the hospital's president and CEO.

"This has ... grown from an inpatient unit to a behavioral health pavilion, where we're looking more broadly at how do we care for the broader issues of mental health in our community. So we've evolved," she said. "The way ... you do with physical health, you probably spend more time going to the doctor, going to outpatient diagnostics, than you ever do in an inpatient, correct? ... Well, similar for mental health. The majority of people never need an inpatient unit."

Construction is expected to begin this fall and to take more than a year.

The outpatient unit will function like a doctor's office, Easton said, "Except, it's a psychiatrist instead of a cardiologist or endocrinologist."

The family resource center will offer help beyond the clinic, such as support groups facilitated by experts on behavioral health, said Alicia Stanislaw, service line director of psychiatry, women and children.

"We're certainly looking forward to creating new support services that aren't currently ... in Caldwell County," Stanislaw said.

The inpatient unit will be meant for individuals who are "acutely" mentally ill and at risk of harming themselves or someone else, Stanislaw said.

The hospital will recruit a team of experts, including several psychiatrists, to work at the facility, Easton said. Currently there are no psychiatrists practicing in Caldwell County.

Among the indicators of the need for mental health care is the suicide rate, which in Caldwell County has been rising steadily since 2001, according to data from the state Department of Health and Human Services. From 2001 to 2005, the rate was 12.9 deaths from suicide per 100,000 residents, from 2006 to 2010 it was 15.8, and from 2011 to 2015 it was 19.8, significantly higher than the state average of 12.7.

Stanislaw said officials hope to make mental health care as routine and as accessible as physical health care.

Easton agreed.

"When Alicia and I moved here 20 years ago, cancer care was that way. It was very difficult to navigate. ... It was difficult to get a diagnosis. ... And we've come so far in building in this community a one-stop-shop for cancer care," she said. "We want to accomplish the same kind of help and hope for people who are challenged by mental illness."

In a separate but related project, the hospital will create space near the emergency room for patients in need of mental health care, Easton said. Some space that was intended to be classrooms will become the emergency room's behavioral health zone, dedicated to patients who are being held while waiting for space to open in a treatment facility.

"As we discovered and talked and worked through this, we realized that the way we care for acutely mentally ill patients in our emergency room is not really the best that it could be for them or for the other patients around them," she said.

Patients in need of mental health care often end up in the hospital's emergency room, where their stays can range from about a day to several weeks, putting them in what can be a stressful environment, Stanislaw said.

"An individual comes in, and they're in acute crisis. Someone who has a significant, severely depressive disorder, or is bipolar and is in crisis, and they're already having auditory and visual hallucinations or they're thinking of harming themselves or someone else, that's the last place that they want to be in the middle of is a medical crisis," she said.

Easton said that construction is scheduled to begin in April and will be completed no later than April 2019.

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