Mentally ill patients turned
away
By Kirsten
Stewart
The Salt Lake Tribune
September 16, 2006
It hasn't
reached epidemic proportions. But an acute national shortage of
psychiatrists has hit Utah, forcing hospitals and mental health
clinics to ship some of their most critically ill to surrounding
states for treatment.
Statistics on how many patients are being diverted are hard to
come by. But mental health officials say the doctor shortage, a
problem for years, has grown worse in recent months. And they are
scrambling for creative solutions to keep and hire psychiatrists.
Paying the price are patients, their families and their doctors -
a dilemma best illustrated by the shortage at the State Hospital, a
354-bed psychiatric facility in Provo.
As the linchpin of the public mental health system and the
state's only longer-term care facility, the State Hospital routinely
admits patients who can't be stabilized at small regional clinics
and hospital emergency rooms. But because the hospital is short
three psychiatrists, 20 of its beds are going unused, said Dallas
Earnshaw, the facility's director.
The shortage is frustrating for Earnshaw, who recently wangled
money from state lawmakers to open 30 new beds only to see few come
online.
"I can't open them if I can't staff them," said Earnshaw.
But the consequences are most dire for regional mental health
centers and hospital emergency rooms, which are experiencing a
backlog of acute care, or critically ill, patients who are waiting
to get into the State Hospital.
"We always have a waiting list. But now folks are waiting
longer," said Debra Falvo, executive director of Valley Mental
Health in Salt Lake County.
Acute care units are geared for short stays, averaging seven
days. The idea is to get a patient stabilized and then referred to
outpatient clinic, or in more severe cases, to the State Hospital.
But, Falvo said, "We recently had someone in acute care for 112
days."
This hurts patients' pocketbooks and their health, said Falvo,
who says acute care units aren't equipped or staffed to offer
behavioral management or cognitive therapy. They're also very
expensive.
Coping with their own doctor shortages, full service hospitals,
such as University Hospital and its Neuropsychiatric Institute,
suffer the same domino effect and sometimes turn away patients, said
Falvo.
"We have so few beds in the state that there have been nights in
the year where our centers have looked across state lines for an
acute care opening," she said.
Utah has fewer psychiatrists per capita than in other states,
ranking 41st nationally, according to the U.S. Bureau of Health
Professions.
Experts blame the shortage on the extra years of training
required of psychiatrists and the increased demand for mental health
treatment as more advanced drugs are developed. It shows no signs of
improving as the workforce ages and universities struggle to recruit
the professors needed to train new workers.
But for now, Earnshaw is optimistic. Despite offering slightly
below-market salaries, employee turnover at the State Hospital is
low, he said.
To avoid burnout, the hospital has boosted overtime compensation
for its 13 physicians who are shouldering extra workloads. Earnshaw
can't afford to hire professional headhunters, as some states have.
But through creative advertising, even recruiting doctors from
overseas, he said he hopes to fill two of his three openings soon.
"When we put the call out, we get good receptivity," said
Earnshaw. "But how how are you going to recruit somebody if there's
nobody out there?"
kstewart@sltrib.com
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