Combining psychiatric beds, emergency services, and psychiatric emergency rooms in one South Carolina region could create a statewide model, health leaders say.

The Department of Health and Human Services is leading a task force that includes the Medical College of South Carolina and other health systems and state agencies. The group will hold its first meeting at the end of August and again at the end of September, followed by monthly meetings.

The initial focus is on creating a behavioral health system in the Phi Dee area, including new mental health hospital beds. On average, he has one bed for every 2,600 people in the state, but in Pee Dee, he’s closer to one for every 7,000 people, said HHS director Robbie Kerr.

The department has raised $65 million in funding from the state legislature for this effort, but partnerships with MUSC and McLeod Health also allow other one-time funding to be used.

“This is one of the areas in the state that has a shortage of inpatient beds,” Carr says. “So we intend to improve it and MUSC is working very closely with us to implement a proposal that will hopefully be funded… quickly to.”

It has not yet been decided where it will go within the area. MUSC and McLeod are considering multiple sites in and around Florence.

The goal, he said, is to have a plan ready for presentation to the governor and Congress by January.

“I want to go into January and say, ‘You’ve spent our money wisely in the sense that we have a plan for Congress to see,'” Kerr said.

mental healthcare model

Inpatient beds take the longest to plan and build, but many other details about the model are still being explored, said MUSC Health System CEO Patrick J. Cawley, Ph.D.

“Not everyone needs hospitalization (treatment). “Some people will be fine in a crisis and stability center, and some people will be fine in a psychiatric emergency room if they stop quickly.”

The state has already identified a shortage of Crisis Stabilization Units, centers where patients can stay for short stays for intensive care, as a real need in South Carolina. It is the only such unit in Charleston and is currently operating at half capacity. The South Carolina Department of Mental Health has been working to establish other organizations statewide, with talks in Columbia, Greenville, and Anderson at various stages.

Pedee Models will also consider creating new units, but Kerr said it is looking to connect.

“We want to build them and network with other mental health resources such as mobile crisis teams,” he said.

The idea of ​​a dedicated psychiatric emergency room is also a new concept that should be considered, Carr said.

“Do you have a dedicated mental health emergency room? And how are referrals handled?” he said. “That will be the committee’s first big focus.”

This is an issue MUSC addresses “every day,” Cawley said. “I talk about it every day. Right in our emergency room in Charleston[waiting for a room]there are 20 he’s, he’s 30 patients on board, and most of those patients are (I have a biobehavioral problem).”

It’s happening all over South Carolina, he said.

“It’s happening to some degree in every emergency room statewide,” Cawley said. These hospitals are looking for solutions, and the goal of the Pee Dee project is to bring together what works for them, Carr said.

“We’re using Pedee as an incubator for this,” he said. With this desire, I plan to use it as a model to test things on Pedee.”

This includes whether psychiatric ERs should be located next to regular ERs, where crisis stabilization is located, and where clinics for outpatient care are located in relation to inpatient beds. Cawley said it includes considering important questions such as whether there is

addiction treatment

Connectivity is key to the model, delivering the right care at the right time, said MUSC President Dr. David J. Cole.

“It’s about access and continuity of care. That’s the first step,” he said. It’s one thing for a crisis to stabilize, but “if you’re in crisis mode, it’s not acceptable to make an appointment to follow up in four months,” Cole said.

It also means addressing the opioid crisis and ensuring mental health services don’t rule out drug and alcohol treatments, Carr said. Some speculate the opposite is also true. “We have to find a way to bundle these services into a (common) configuration. That’s one issue we’re going to look very closely at.”

This is a serious problem for mental health providers right now, Cawley said.

“We run into this all the time,” he said. “We have patients and we refer them to health care providers and they say, ‘I don’t treat people with alcohol or substance abuse (problems)’ or vice versa. ”

fill the gap

Despite looking to modernize the system, Palmetto faces a severe shortage of providers. As of Sept. 9, the state’s Department of Community Mental Health Services had 515 vacancies, mostly in clinical positions, due in part to a lack of competitive salaries, said the department’s deputy director. said Deborah Blalock. While we may not be able to solve that workforce problem quickly and easily, Cole said there are better ways to use the state’s existing resources.

“We are creative in changing the model,” he said. “We have a huge strength in terms of telemedicine, which has had a huge impact on the delivery of behavioral therapy, leveraging the healthcare providers we have. I think it’s more of a long-term commitment than training to change the model of how we care.” “

State leaders are aware of that and were ready to help when they were asked to help fund workforce development last year, said MUSC’s head of government affairs. Mark Sweatman said.

“From a legislative perspective, I have never seen an issue where the governor, Secretary Carr, legislative leaders, the House and the Senate are all on the same page,” he said. “They acknowledged it in a heartbeat.”

From a hospital perspective, Cawley said there is great interest in having a new model for addressing the current shortage of crisis management services.

“I don’t think of this as MUSC at all,” he said. “Other hospital systems are starting to get involved. There’s a lot of interest. We’re hearing through the hospital association.”

And it cannot be entrusted to states to lead and fund it, Kerr said.

“If you try to treat this as a public initiative, you will fail,” he said. “It should be an across-the-board initiative for all providers.”

Doing nothing is no longer an option for anyone, Cole said.

“In my opinion, we’re at the forefront of a behavioral health crisis, a tsunami, whatever word you want to use.” and impacts our society.”