The only area hospital offering inpatient psychiatric treatment for adults will end those services next month — leaving AltaPointe as the area’s only such provider and public safety officials concerned with growing gaps in Alabama’s mental health system.
According to Mental Health America, inpatient psychiatric service allows a period during which patients can be “closely monitored to provide an accurate diagnosis or adjust or stabilize medications but also during acute episode when a person’s mental illness temporarily worsens.”
Mobile Infirmary announced last week it would no longer be providing those services for adults under the age of 65 and would be transitioning the 17 beds in its current unit to similar geriatric psychiatric units in Mobile and Bay Minette that exclusively treat patients 65 and older.
In a statement to Lagniappe, a representative of Mobile Infirmary said the shift was part of a continuing commitment to serving a “rapidly growing senior citizen patient population.”
“This means that each one of the local hospitals and emergency departments now provide the same capabilities and capacity for adult psychiatric patients,” Infirmary’s statement reads. “All emergency departments in Alabama are qualified and have the capability to medically screen and stabilize a potential psychiatric patient under Emergency Medical Treatment and Labor Act.”
Enacted in 1986, EMTALA is an unfunded congressional mandate requiring emergency departments to stabilize and treat any patient regardless of his or her insurance status or ability to pay.
In other words, like other area hospitals, Infirmary will still be able take in emergency psychiatric patients and triage their medical needs. However, for those requiring an extended stay, the only remaining option in Mobile and Baldwin counties is AltaPointe.
While 17 fewer beds might not seem like many, it’s a continuation of a trend many hoped had peaked with the closure of Searcy Hospital in 2012. To put it in perspective, those 17 beds were 10 percent the total beds still available for adult psychiatric patients in coastal Alabama.
While AltaPointe is one of the largest behavioral health care systems in the nation, it only has around 182 beds dedicated to inpatient psychiatric care locally. The trouble is, 100 of those are for children, and of the remaining 82 adult beds, 16 are not in service due to lack of funding.
Some patients can seek those services voluntarily but AltaPointe also takes involuntary admissions under petition from the Mobile County Probate Court.
April Douglas, AltaPointe’s director of public relations, said it was “alarming and concerning” that a metropolitan area the size of Mobile would soon have no hospitals with the ability to serve adult patients suffering from acute psychiatric illnesses.
“AltaPointe has the capacity to open up the needed bed space we just do not have the financial ability to operate,” she added.
Douglas did say AltaPointe provides psychiatric consultation services for eligible patients in Mobile area hospitals but only provides inpatient care at its own facilities in Mobile and Daphne.
Lagniappe has previously reported that as mental health care facilities close, many patients often go without the care they need. When those individuals wind up on the streets, local law enforcement agencies, first responders and jails are typically left to pick up the slack.
Mobile Public Safety Director James Barber said that can create very difficult situations for police. In addition to being a threat to officers and the public, Barber said individuals experiencing a psychotic episode are also suffering a potentially fatal medical emergency themselves.
According to Barber, current MPD protocol calls for officers to transport subjects in need of psychiatric care to the nearest emergency room. He said the department’s training focuses on minimizing injury, de-escalation and on how to proceed once a situation has been stabilized.
“We work on making sure officers can do triage and determine whether Metro Jail is appropriate or maybe a hospital, depending on the individual situation,” Barber added. “However, law enforcement officers are often in situations where the only option they have is to incarcerate these individuals in local jails, which we understand is not what they need.”
Since city leaders were made aware of Infirmary’s plan to limit psychiatric care options, Barber has been meeting with the leadership of stakeholding agencies in the area, including officials overseeing the Mobile County Metro Jail and the leadership at AltaPointe.
Including those dealing with substance abuse, Barber said roughly one-third of all the inmates in Mobile Metro Jail have some kind of mental illness. That’s not uncommon in a state where around 20 percent of the prison population receives some kind of mental health treatment.
Alabama is attempting to revamp those services after a federal court ruling found “woefully inadequate mental health care” available in state prisons inflicts “real, concrete and terribly permanent harm” on mentally ill prisoners.
Asked about Infirmary’s decision to scrap its adult inpatient unit, Mobile County Health Director Bert Eichold described it as yet another reason state officials should look into reopening Searcy Hospital — an idea he’s floated to Alabama. Gov. Kay Ivey.
If the Alabama Department of Mental Health were to find the funding, Eichold said, reopening Searcy in Mount Vernon — a facility the state still owns — would quickly increase the area’s capacity for psychiatric care by as many as 100 beds.
“My proposal was to turn Searcy into a correctional facility for nonviolent offenders who have mental issues or substance abuse problems,” Eichold said. “This is the time to help with overcrowding in Alabama’s correctional facilities and to take care of our residents with mental health issues. Searcy is an asset of the state that could help in either in situation.”