Subscribe to The Brief, The Texas Tribunes daily newsletter that keeps readers up to date on the most essential Texas news.
For 24/7 mental health assistance in English or Spanish, call the Substance Abuse and Mental Health Services Administration’s toll-free helpline at 800-662- 4357. You can also contact a trained crisis counselor through Suicide and Crisis Lifeline by calling or texting 988.
Statewide, rural hospitals are facing a shortage of mental health care providers, with more than 60% of rural counties designated as Provider Shortage Areas by the Services and Resources Administration sanitary
At the same time, the number of people experiencing mental health crises has increased, and these patients are often forced to seek care in the emergency rooms of rural hospitals, where they face long waits for treatment and use up the resources needed by critically ill patients. conditions
Terry Scoggin, CEO of Titus Regional Medical Center (TRMC), says his and other rural hospitals’ emergency room is the primary place mental health patients are taken even though ER doctors are not trained in treat mental health conditions.
“The emergency department is a very hectic, chaotic, life-or-death area. It’s not the best environment for a mental health person or a person with a drug overdose,” Scoggin said.
Emergency rooms are the last resort for rural mental health
Located in rural northeast Texas near the Arkansas border, Titus County has one psychiatrist and four licensed clinical social workers to serve 33,000 people in Titus and surrounding counties. Given the population, that’s about two-thirds fewer providers than the rest of the state, according to the Texas Department of State Health Services.
Mental health providers in Titus also serve patients from surrounding counties that have even fewer resources.
“We have a psychiatrist in all five counties that we support. That gives you an idea of the lack of opportunity,” Scoggin said.
Without preventive care, people experiencing mental health crises in rural counties like Titus end up in the ER. Some are brought there after a public disruption. Others are brought by relatives.
Once in the ER, patients can spend days or even weeks waiting to be screened by a local mental health authority before they can be discharged or transferred. For patients at Titus Hospital, which doesn’t have a psychiatrist on staff, that’s the Mount Pleasant Mental Health Clinic, which serves four counties and struggles to keep up with patient testing.
In Titus, patients with mental health needs are often transferred to Terrell State Hospital, but waits are also long.
“Terrell gets full. It’s like, it’s not us, it’s Terrell,” said Rachelle Sills, director of the Mount Pleasant Mental Health Clinic. According to Sills, his team calls Terrell every day when trying to transfer a patient, sometimes waiting up to 14 days for an opening.
Kathy Griffis is the vice president of clinical operations and chief nursing officer at Titus Regional Medical Center. She cares about patients with mental health issues, but also her staff, who sometimes deal with violent patients during extended stays in the ER.
Brittany Bacak, a licensed clinical social worker, said the isolation mental health patients experience while waiting in the ER can exacerbate their symptoms, leading to violence toward staff.
“When you put a client in a room and tell them they have to stay in that room and they can’t leave that room for several days, people get agitated, don’t they?” said Bacak, a professor of ‘School. in Social Work from Texas State University, who spent eight years working in Texas emergency rooms in both rural and urban hospitals in Bastrop, San Marcos and Austin before teaching.
Telehealth in emergency rooms could reduce violence and achieve more timely patient care
Concerned about the long waits experienced by mental health patients in rural emergency rooms and the associated danger to staff, Griffis worked with colleagues at Baylor University Medical Center and St. Lukes Health in Lake Jackson to explore the use of telehealth to help ER physicians treat mental health patients. that end up in your department.
A year later, the state legislature appropriated $7.4 million over two years to fund telepsychiatry consultations in rural hospitals, building on the work of Griffis and his colleagues.
A pilot program was launched in Titus and Knox counties in March. Texas Tech psychiatrists hired by Texas Health and Human Services are available at rural hospitals seven days a week, 10 hours a day, allowing ER physicians to begin treating mental health patients in the ER during the first 24 hours
“Now at least we can get a diagnosis, a prescription and possibly a discharge to society and not a discharge to another hospital,” Scoggin said.
Sills, at the Mount Pleasant Mental Health Clinic, welcomes the program because it will reduce workload and help move patients to a more appropriate care setting in less time.
“We’re a high-crisis, high-volume clinic here that I think local psychiatrists (via telemedicine) will really help the ER move some of these people faster, whatever that means, get them elsewhere or to advise them,” Sills said.
Griffis hopes to demonstrate the effectiveness of the programs and secure future funding, but the challenges of providing mental health care in rural areas extend beyond ER. Due to a shortage of providers, access to ongoing mental health care in rural communities is challenging, even for those with private health insurance.
“I think we need to overhaul our community’s infrastructure for mental health,” Scoggins said.
Liza Kalinina is a graduate student at Texas State University and an intern at Texas Community Health News, a collaboration between the School of Journalism and Mass Communication and the university’s Center for Translational Health Research. TCHN stories, reports and data visualizations are provided free to newsrooms across Texas.
Disclosure: Baylor University has been a financial supporter of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations, and corporate sponsors. Financial supporters play no role in the Tribune’s journalism. Find a full list of them here.
We’ve got some big stuff for you at The Texas Tribune Festival, September 57 in downtown Austin. Join us for three days of big, bold conversations about politics, public policy and the news of the day.
#rural #Texas #emergency #rooms #facing #growing #mental #health #crisis
Image Source : www.texastribune.org