Long waits, delays the norm for psychiatric patients - Newsday

Busy mental health centers are passing off patients to other institutions that face the same problems.

BY LAUREN E. TERRAZZANO
lauren.terrazzano@newsday.com

A Suffolk hospital that serves as a mental health hub to evaluate emergency psychiatric cases has been increasingly diverting patients to other centers as the demand far outweighs its resources, state and local health officials say. The Stony Brook University Medical Center was on "diversion" for nearly half of January, and for 12 days so far in February, according to records and interviews.

As a result of high patient loads, the mentally ill who are escorted by police for emergency care have been subject to long waits and delays in evaluation and treatment, or have been taken elsewhere, where they face similar waiting lags, officials say. And the county's already fragile mental health network has gotten increasingly backed up as people are delayed from entering long term treatment, local officials said.

"It's an issue we have to be very concerned about," said Thomas MacGilvray, the county's director of community mental hygiene. Those being diverted are specifically in the custody of Suffolk County police and sheriffs, MacGilvray said. The waits can be as long as seven or eight hours, and police are required to wait with them. As of Monday, the hospital was not on diversion, and was accepting patients to its 18 observation or extended-stay beds.

He said the problem has been exacerbated by the county's overall lack of hospital beds, the lack of community mental health day programs and the temporary closing of 25 beds at Bay Shore's Southside Hospital mental health unit because of renovations.

At Stony Brook, the Comprehensive Psychiatric Emergency Program serves mentally ill children, adolescents or adults. Officials there said they are working to make things better and reduce waiting time.

Calling it a statewide issue, Dr. Mark Sedler, Stony Brook's chairman of psychiatry, attributed the diversions to a decline in statewide psychiatric beds overall, "and are a symptom of the inadequacy of the whole system."

He said when the unit was designed in 1990, officials expected that it would need only four extended beds to observe patients. As Long Island's state-run psychiatric hospitals shut their doors and the number of outpatient programs didn't keep pace, the backups started to increase, he and others said.

"Our field office is working closely with the county mental health department to address the issue that is involved," said Jill Daniels, a spokeswoman for the state's Office of Mental Health.

Sedler said Stony Brook houses from seven to 18 unit patients. "We have a limited physical capacity. It's a locked unit, a very defined physical space," he said.

Part of the problem, he said, is that some patients are intoxicated and may require eight or more hours before evaluation, or the hospital may have trouble reaching a family member or getting medical test results. And some patients are homeless.

According to records, the state's Office of Mental Health last reviewed the unit in 2004, and found that 400 individuals waited at least six hours to see a physician. There are about 6,000 visits to the unit annually. It is due for another review in April, when it reapplies for its new operating certificate.

"For me, it's like waiting for the other shoe to drop," MacGilvray said. "People in need of acute psychiatric care aren't getting it, and I'm concerned about what happens while they're waiting."
Copyright 2007 Newsday Inc.