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Mental Health Advocates Concerned By Loss Of Inpatient Beds At Tri-City

Tri-City Medical Center in Oceanside, June 2018.
Nicholas McVicker
Tri-City Medical Center in Oceanside, June 2018.
Mental Health Advocates Concerned By Loss Of Inpatient Beds At Tri-City
Mental Health Advocates Concerned GUEST: Alison St John, North County reporter, KPBS News

A decision by the Tri-City hospital board last week has significantly reduced the treatment options for North County patients in need of acute inpatient mental health care within the next 60 days. Tri-City hospital in Oceanside will close both its 18 bed behavioral health unit and its new stabilization unit. The hospital plans to increase outpatient mental health services help ease the blow. But mental health advocates say closing inpatient beds decreases North County's ability to help people suffering a mental health crisis. Joining me is Cape UBS North County Reporter Alison St. John. Alison welcome. Glad to be here Maureen. Tell us a little bit about Tri-City. This is a community hospital right. What does that mean. It's one of the last community owned hospitals in San Diego County which means that the board that governs it is elected by the people. It was founded back in 1961 and it serves Vista Oceanside Carlsbad that sort of coastal North County community. So it has quite a wide catchment area. Why is this behavioral health units so important to North County. Well the there is not a lot of beds for people who are in crisis mental health services are very difficult for hospitals to fund. And in the past the Tri-City board has talked about the difficulties of the emergency room being flooded with people who have mental health crises. So they did have 29 beds. And apparently there's only about 97 beds around the whole county. So this is almost a third of the county's emergency beds and there are certain situations where somebody is in a crisis where it's not suitable you know for someone just to pop round to their home or do outpatient services might not happen between 7:00 in the morning and 5:00 in the evening. It might happen in the night and they need to be taken into a secure facility. And so you're talking about the kind of patients that need immediate care and immediately need to be placed in a hospital situation because of their mental health crisis. That's right. And 51 50 as is the law that cited often that allows law enforcement or the team you know the psychiatric emergency response team to hold somebody for up to three days in service of their treatment so that they can really get stabilized. Now what does the hospital board say will happen to those who are severely ill that they are thought to be a danger to themselves. So the hospital board is saying you know we're not abandoning these people we're going to up our outpatient services. There are other beds around the county where somebody who needs an inpatient bed can be taken. They say they're going to be hiring more staff. It's interesting though because they do seem to have 200 open positions which suggests that they're having a hard time finding enough staff enough qualified staff. I've heard various reasons why that is one of them is just the lack of affordable housing and in North County. So they're looking for more staff to do outpatient services. But the the mental health advocates are saying that this inpatient unit was really a very vital part of the crisis intervention services in the county. Now listen I want you to talk to us a little bit more about the reaction from mental health advocates to this closing and what law enforcement is saying about it. Well I spoke with Catherine Icaria who is the head of San Diego's NAMI the National Alliance on Mental Illness and she said this is really a problem for the system as a whole because it is not easy to sustain inpatient services for any kind of health treatment let alone behavioral health and that these 29 beds will amount to approximately a third of all the beds around the county. It's going to be challenging for the residents of North County because the need is so great for inpatient services from what I understand Palomar in Colorado folks have a waiting list to their inpatient units. There's not going to be the availability of Amedi acute treatments that many the clients need to be able to start their own journey to our recovery. And I think law enforcement feels that quite justifiably that they're being landed up with some problem situations that they are not necessarily trained to deal with and that even if they are called out they don't have anywhere to take people who are in a crisis. What is the board saying about why they made the decision. What are the reasons that they're closing this inpatient mental health unit. Well the most immediate reason is one of new state laws which requires them to do some modifications physically to the building. Apparently it would cost 3 million dollars to change the ceilings that drop ceilings which unfortunately have led to people committing suicide in the past. So new state laws are good but if it results in the closing of the facility altogether that's good. And then they also mentioned that there was a 5 million dollar loss on the unit last year and there was a lack of psychiatrists around the nation have difficulty in hiring psychiatrists. I think psychiatrists are being reimbursed at levels in public hospitals which are less than many people with that training would accept and so they tend to choose to go into private practice. Will the closing help Tri-City stay in business as a community hospital. Well it might be one thing that that prevents the financial problems that are constantly facing Tri-City. I mean Tri-City has not been able to pass a bond to update its facilities to meet earthquake standards. They've tried three times and have failed they've gotten a loan loan from HUD. But it may or may not be enough. So I think this is a hospital that is really facing serious financial challenges and this is just a little tip of the iceberg we're seeing here. I've been speaking with the North County Reporter Alison St. John. Alison thank you. A pleasure. Maureen.

Mental health advocates are reacting to the decision by Tri-City Medical Center in Oceanside to close its inpatient mental health and crisis stabilization units.

Tri-City Medical Center is a community district hospital run by a publicly elected board. The board has decided to suspend operations of the hospital’s inpatient mental health services and expand outpatient services

Cathryn Nacario is CEO of the San Diego chapter of NAMI, the National Alliance on Mental Illness. She said the loss of Tri-City’s inpatient behavioral health services may affect psychiatric emergency response or PERT teams, who work with law enforcement to provide appropriate responses to crisis situations.


"It really does leave a big void in the North County community," she said, "with 29 beds going away for inpatient services."

Nacario said that is almost one-third of the inpatient mental health beds in North County.

"It’s going to be challenging for the residents of North County," she said, "because the need is so great for inpatient services, Palomar and Pomerado both have waiting lists for their inpatient units, so there’s not going to be availability of immediate acute treatment that many of these clients need to start their own journey to recovery."

Tri-City Medical Center did not respond to requests for an interview but said in a statement that aging facilities and new federal regulations, plus a shortage of psychiatrists, caused the shutdown. About 80 employees will be transitioned to other positions.

Mental Health Advocates Concerned By Loss Of Inpatient Beds At Tri-City
Mental health advocates are reacting to the decision by North County’s Tri-City Medical Center to close its inpatient mental health and crisis stabilization units.

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