Dec 15th, 2016
This article originally appeared in the Longview News-Journal.
As the rural East Texas population ages, the Longview area is facing an "absolutely critical" need for mental health services — a need private behavioral health hospitals are struggling to meet.
"There is a lack of mental health services in this area," said Lauren Weber, administrator of Oceans Behavioral Hospital, a 24-bed hospital with an outpatient center in Longview. "The need for our services is increasing every day."
Almost 40 percent of Americans with serious conditions do not get help, she said — and the rates are even higher among the senior population. Rural residents also face a special set of challenges.
More than 15 million rural Americans face behavioral health issues such as substance abuse and mental illness, according to a report released in September by the Rural Health Research & Policy Centers in Grand Forks, North Dakota.
About 11 inpatient hospital beds exist for every 100,000 Americans with mental health challenges, according to Kerry Driskell, community liaison director at Oceans, which is part of a network of 16 hospitals in Texas and Louisiana.
The need for inpatient and outpatient services for people with behavioral problems is "absolutely critical," said Dr. Ivan Pawlowicz, medical director of behavioral health at Good Shepherd Medical Center in Longview.
"There are significantly more resources available in your larger metropolitan area," he said.
Pawlowicz, a psychiatrist, said the private hospitals in Longview and Kilgore are "essential" in meeting the needs of geriatric mental health patients. But, he said, he is unaware of any behavioral hospitals serving youths in the immediate area.
He was referring to Oceans on Clinic Drive in Longview and Allegiance Specialty Hospital, which occupies the former Laird Memorial Hospital on Henderson Boulevard in Kilgore.
Oceans provides inpatient services to patients 50 and older, while Allegiance operates a 60-bed hospital with two specialties: medical acute care and behavioral health care, primarily for patients 55 and older.
The 76-bed Behavioral Hospital of Longview opened in 2011 on Bermuda Lane but closed its doors after the Centers for Medicare & Medicaid Services notified its director it would end Medicare reimbursements in July because of "alleged deficiencies."
Behavioral Hospital officials were not available for comment on whether and when the hospital would reopen. Allegiance also was unavailable for comment through its corporate office in Shreveport.
Different patient groups
The closure of Behavioral Hospital, however temporary, has not necessarily benefited Oceans, because Oceans serves a different age group, according to Weber, a licensed clinical social worker. She said Oceans reduced the age it serves from 55 in June because the need exists.
"We stay full," Weber said, adding the average daily count is 20 patients with an occupancy rate from 80 percent to 85 percent.
Weber, who started at Oceans when it opened in November 2011, recently said 450 people had stayed in the hospital so far this year, an increase of 25 percent to 30 percent over the same time frame in 2015. The waiting list is a maximum of four days.
Oceans staff treats the bulk of its patients for major depression, Weber said.
They also treat dual diagnoses, such as a person with schizophrenia who also has underlying substance abuse problem.
Its outpatient client serves adults ages 18 and older who undergo group therapy sessions three to four times a week.
The hospital also cares for patients with behavioral problems associated with dementia, which can set in when someone is in their early 50s, Weber said.
Oceans has 54 full-time employees including registered nurses, licensed vocational nurses and certified nurse aides, Weber said. The hospital also contracts with a psychiatrist, doctor of internal medicine and a nurse practitioner.
Employees undergo extensive training, including how to deal with aggressive and potentially violent behavior, Weber said.
Weber said most patients stay anywhere from 10 to 14 days, while some are released in as few as four days.
Hospital staff discharges patients only if they have a solid plan that includes after-care such as appointments with psychiatrists and their primary care doctors.
She acknowledged some discharged patients return to Oceans, perhaps because they failed to follow their plans.
Oceans gets referrals from doctors, emergency departments, nursing homes, hospices and the court system, Weber said. Patients come from the Longview area and as far away as Texarkana.
Weber said Oceans staff plays a role to destigmatize mental illness, which she acknowledges still is considered a taboo subject.
"We strive here to educate families, the community in general," Weber said. Employees visit medical offices and long-term care facilities to explain the services Oceans provides.
Weber said employees are passionate about taking care of people with mental illnesses.
"I love my job here," said Cheryl Kufahl, a RN who started as a floor nurse 3 1/2 years ago and now is responsible for performance improvements and infection control. "I just love these kinds of patients."
Kufahl said her late mother had Alzheimer's, and that experience inspired the former stay-at-home mom to pursue a nursing career.
She described the patients as a "very special population. Mental health gets overlooked quite a bit and (is) a little bit misunderstood. We need to bring more awareness."
Down the corridor, nurse practitioner Lisa Van Diemen said she sees patients three times a week.
"All I do is manage the medical care, like blood pressure (and diabetes)," she said. She said she tries to make sure patients comply with their medical care, such as insulin for diabetics.
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