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Urgent Care Centers Opening For Mental lllnesses

MedpageToday

LOS ANGELES -- Hoping to keep more people with mental illness out of jails and emergency rooms, county health officials opened a mental health urgent care center Wednesday in South Los Angeles.

The goal of The Martin Luther King, Jr. Mental Health Urgent Care Center is to stabilize and treat people in immediate crisis while connecting them to ongoing care. Run by Exodus Recovery, it will be open 24 hours a day, seven days a week and can serve up to 16 adults and six adolescents. During their stay of up to one day, patients will undergo a psychiatric evaluation, receive on-the-spot care such as counseling and medication and be referred for longer-term treatment.

The center can take people in severe crisis and expects many will be brought in by police and paramedics, said Connie Dinh, vice president of nursing services for Exodus. But she said it cannot accept people who are incoherent, extremely aggressive or need emergency medical attention. They will still need to be treated at hospitals or inpatient psychiatric facilities.

Staff will be able to place people on 72-hour psychiatric holds if they are a danger to themselves or others.

Mental health urgent care centers, also known as crisis stabilization units, are opening throughout California in response to the shortage of psychiatric beds and the increase in patients with mental illnesses showing up at hospital emergency rooms with nowhere else to go, experts and advocates said. In Los Angeles County, four such centers have opened and several more are planned.

L.A. County's mental health director Marvin Southard said the centers are a more effective way to care for many patients with mental illness and are less disruptive to hospitals. And county Supervisor Mark Ridley-Thomas, who led the effort to open the center, said they are "more humane" and a smarter approach.

Hospitals statewide saw a 47% increase in encounters with patients with mental health needs between 2006 and 2011, compared with a 14% increase in all patients, according to the California Hospital Association. Mental health urgent care centers can help relieve the burden on emergency departments, get patients the care they need and reduce healthcare costs, said Sheree Kruckenberg, vice president of behavioral health at the association.

"As we are trying to bend the cost curve, to me this is a slam dunk," she said.

Ron Honberg, policy director for the National Alliance on Mental Illness, said that the centers are a great place to respond to crises, but the centers are "just one piece in a more complicated puzzle" and people need to be linked to community services.

The Martin Luther King Jr. center is a two-story building near the campus of a community hospital expected to open next year. The first floor has reclining chairs surrounding a nursing station, a kitchen, seclusion rooms and offices for mental health providers.

Upstairs, there are rooms for family meetings, counseling and support groups on topics including anger management and independent living skills. There will also be substance abuse counseling and a social services worker who can help enroll people in cash assistance and other programs.

The center will also serve as a medical clinic. Patients ideally will see the clinic as their "medical home" and return often, said Dr. Mark Ghaly, director of community programs with the county Department of Health Services.

Ghaly said it makes sense to have a primary care clinic at the urgent care center. "People with mental illness don't like cookie cutter clinics," he said. "This is familiar."

Jo Helen Graham, whose 36-year-old son has schizophrenia and has spent time in hospitals and jails, said she believes he and others like him will benefit from the center. "We need some place our mentally ill children can go," she said. "We need ongoing supports."

Disclosures

This article, which first appeared Aug. 28, 2014, was reprinted from with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.