In the December 26, 2012 issue of the New York Times, an article:“Storm Weakened a Fragile System for Mental Care” discussed the problems associated with the loss of psychiatric services in New York as a result of Sandy’s destruction. In the discussion of this in the article and in the 127 comments posted so far in response to it, there are many complaints about the lack of non-institutional mental health services; no mention is made of such community-based programs as clubhouses.
One of the most affected hospitals, Beth Israel, recorded a 69 percent spike in psychiatric emergency room cases last month, with its inpatient slots overflowing. Instead of admitting more than one out of three such cases — as it did in November 2011, it admitted only one out of four of the 691 emergency arrivals this November, records show. Capacity was so overtaxed that ambulances had to be diverted to other hospitals 15 times in the month, almost double the rate of the same period in 2011, in periods typically lasting for eight hours, officials said.
Dr. Richard Rosenthal, Physician-in-Chief of Behavioral Services for Continuum Health Partners, Beth Israel Hospital’s parent organization, said he was proud of how much Continuum’s hospitals had done to handle psychiatric overflow. Yet these days, he said, as he walks on Amsterdam Avenue between Continuum’s Roosevelt Hospital on West 59th Street and its St. Luke’s Hospital on West 114th Street, he notices more mentally ill people in the streets than he has seen in years.
“When you have the most vulnerable folks, all you need is one chink in the system and you lose them,” Dr. Rosenthal said. “Whether they lost their housing, or the outpatient services they usually go to were closed and they were lost to follow-up, they have become disconnected, with predictable results.”
What this writer is both astonished and disheartened about Dr. Rosenthal’s comments is his total disregard of the role that community-based programs can and do play in such emergencies. In the NYT article he is pictured outside St. Luke’s-Roosevelt Hospital Center which works very closely with Fountain House (clubhouse) and the Sidney Baer Center (community-based psychiatric and primary care services center). After Sandy struck these outpatient services contacted over 1000 members to confirm their status and provide help, if needed.
There are 10 other New York City certified clubhouses that actively provide services throughout the metropolitan area. What Dr. Rosenthal, other hospital-based psychiatrists and mental health providers need to do is reach-out to these programs. One sure result, which has been documented at St. Luke’s-Roosevelt Hospital is the easing of demands for ER and inpatient services. If the problem in reaching-out is an inability to communicate, “interpreters” exist at the Sidney Baer Center, for example.
The bottom line being: Can we please learn from the Sandy disaster that communication and partnership development between hospitals and community-based services must be established.
We apologize for the delay in posting this commentary but must admit we were hard-pressed to come up with a positive response to such an extraordinary oversight, as well as recuperating from a bout of the current flu-demic As usual, your comments and opinions are welcomed either below or on our e-mail address: tandcassociates@gmail.com.