18 July

3 years ago Riley Hospital heralded a new mental health unit. Now it's closed.

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Three years ago Riley Hospital for Children opened a psychiatric unit amid much fanfare, saying it would provide much-needed care for children and adolescents with conditions ranging from anxiety to eating disorders to bipolar disorder.

But this spring, the hospital quietly shuttered the 20-bed unit, which included safe rooms especially designed for patients who might harm themselves.

And Riley is not the only hospital to make such a decision, experts say, as insurers direct patients to treatments that don't involve expensive hospitalizations.

The closing at Riley does not leave the parents of troubled children without options, but it does come at a time when advocates for pediatric mental health services decry a lack of resources, including available hospital beds for patients whose needs cannot be addressed outside of a hospital setting.

Yet hospital officials declined to go into detail about the rationale behind the closure. In an emailed statement Riley officials said only that they were considering the best way to provide dedicated behavioral health services.

“As such, we are taking time to assess our community’s needs to assure that the right services are inplace to help children thrive and adjust our role accordingly,” the statement read. “While inpatient behavior health programs currently have been suspended, our multidisciplinary care team continues to offer a full range of pediatric mental health services.”

Riley's unit opened after the hospital received a $3.8 million grant from the Samerian Foundation, a foundation overseen by local philanthropists Cindy and Paul Skjodt and named for their children. Samerian Foundation officials did not respond to a request for comment about the closing.

IU Health officials said at the time of the opening that moving pediatric psychiatric care from IU Health Methodist to the children’s hospital had several benefits. Not only did it double the number of available beds, it also made it possible for patients’ physical needs to be addressed along with their mental health.

Methodist's behavioral health unit had no space similar to the two safe rooms in the Riley unit. Hospital officials said that they would emphasize teaching patients coping skills rather than dole out drugs.

Now, the closing offers Central Indiana families one less option, at a time when suicide rates for teens and young adults are increasing, according to the American Foundation for Suicide Prevention.

Nor is Riley alone in closing such a unit.

In June Rush University Medical Center in Chicago announced it was closing its 15-bed mental health inpatient unit after the state found deficiencies in the way it protected patients from harming themselves.

Rush officials told the Chicago Tribune at the time that a lack of demand in part led to the decision to close, saying on a typical day only about half the beds were taken.

Experts in the field say runninginpatient behavioral health units is not easy, and several factors may lead such programs to close.

For starters, insurers do not tend to reimburse as well for mental health care delivered to patients in the hospital as they do for physical conditions such as a cancer or other illnesses. Insurers may only cover a few hours of outpatient therapy a month instead of treatment that includes overnight hospital stays.

“What we’re seeing at Riley is the perfect example of how and why it’s so difficult to keep a behavioral health unit open, especially for children who need it,” said Matt Brooks, president and chief executive officer of Indiana Council of Community Mental Health Centers. “The business model to maintain inpatient behavioral health units is extremely challenging in the current insurance reimbursement environment.”

While grant money helped open this unit, it did not provide a long-term funding stream and families with children in need of such care may not be able to afford it.


Source: https://www.indystar.com/story/news/health/2019/07/17/riley-hospital-children-suspends-inpatient-mental-health-care/1717327001/

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