CLEVELAND, Ohio — Health systems in some areas are shrinking, but the MetroHealth System is expanding with the region’s largest investment in behavioral health in decades.

The $42 million, 112-bed MetroHealth Cleveland Heights Behavioral Health Hospital is set to open Saturday, Oct. 8, and treat approximately 5,000 patients. Years of conditions such as bipolar disorder, depression, addiction, mood disorders, double diagnosis, or having both mental illness and substance abuse.

Safety features such as doors that cannot be barricaded reduce the risk of injury. The Behavioral Hospital also has specialized units for treating adolescents and the elderly.

The opening of the Behavioral Health Hospital comes a week before MetroHealth opens its new 11-floor Glick Center on its main campus.

The expansion of Cleveland Heights will increase the number of psychiatric beds available in Cuyahoga County, but not enough to completely solve the problem of too few beds and too much demand. The imminent closure of psychiatric services at the St. Vincent Charity Medical Center made things worse.

Cuyahoga County is set to experience a record number of fatal overdoses this year, and the COVID-19 pandemic has increased demand for mental health counseling. In 2018, he had nearly 5 million emergency department visits with mental, behavioral, and neurodevelopmental disorders, according to the U.S. Centers for Disease Control and Prevention.

A local behavioral health professional praised MetroHealth’s commitment to mental health.

“Wow. So that’s the bottom line. This is great. “The lack of enough inpatient beds in the city of Cleveland is hampering the care patients receive.”

Opening is when another hospital is about to close

But the imminent loss of St. Vincent’s inpatient psychiatric beds and psychiatric emergency room puts additional pressure on MetroHealth to care for the underserved. .

St. Vincent will close its inpatient care, surgery and emergency room services on November 15, instead offering wellness and outpatient services at a location just south of downtown Cleveland.

St. Vincent now has 20 psychiatric inpatient beds and 15 detox beds, and will serve about 1,000 psychiatric inpatients in 2021, the hospital said. Psychiatric emergency rooms with caregivers specialized in psychiatric evaluation and counseling served approximately 3,000 patients annually.

MetroHealth CEO Dr. Akram Boutros said: “From now on, we have to figure out how to increase the service.”

Given MetroHealth’s commitment to addressing the social determinants of health, the hospital placed the new hospital near poor neighborhoods where people see police more often than health care providers, Boutros said.

“How do you tell someone from East Cleveland to get on the bus and come to MetroHealth (on the west side) for treatment?” Boutros said. “So if we were going to do it[developing a larger psychiatry]we were going to do it elsewhere.”

Shortage of psychiatric beds in Greater Cleveland

According to national guidelines cited by MetroHealth, Cuyahoga County has 220 fewer beds than needed to fully meet the needs of its residents. Economic pressure and staff shortages are contributing to the supply shortage.

Many non-profit hospitals do not have psychiatric units. That’s because those departments are often in the red even with payments from private insurance, Medicaid, and Medicare, says Boutros.

“The cost of providing behavioral health and addiction services is much higher than what you pay for,” Boutros said. ”

A leading provider of mental health inpatient beds in Northeast Ohio, the clinic has 269 psychiatric inpatient beds throughout the healthcare system, including 16 chemical dependent beds at the Cleveland Clinic Lutheran Hospital.

Still, patients at the clinic can wait up to 36 hours before being admitted to the behavioral health unit, Pozuelo said.

The university hospital system has 101 psych beds and no detox or substance use beds.

Highland Springs Hospital, a private hospital with facilities in Highland Hills and Solon, and six state-run community mental hospitals also serve this patient population. Cuyahoga County does not have a state-run mental hospital.

Many beds in non-profit hospitals remain empty due to a lack of mental health care providers to staff them.

According to Pozuelo, 15% of the clinic’s psychiatric beds are typically unused due to staffing issues.

Cuyahoga County has about 450 psychiatrists and addiction specialists, according to the Behavioral Health Workforce Tracker developed by the University of Washington in Washington, DC.

In 2019, nearly half of Cuyahoga County residents who needed inpatient behavioral health care had to travel out of the county to get it, according to MetroHealth.

Lack of adequate wages and job stress make it difficult to retain mental health workers. Scott Osiecki, chief executive officer of the Cuyahoga County Commission on Alcohol, Drug Addiction and Mental Health Services, said:

“It’s a tough job. It’s stressful and requires 24-hour (or more) staff,” says Osiecki. “They can actually make more money working at McDonald’s or Walmart.”

MetroHealth anticipates staffing issues and plans to phase in new hospital units over the next few months as it recruits staff. Boutros said the facility plans to reach a full staff of 225 employees in mid-2023.

The system hopes to employ many of St. Vincent’s behavioral health workers. “The sooner we hire staff, the sooner we can open,” he says Boutros.

Inside a behavioral health hospital

Connected next to MetroHealth Cleveland Heights Medical Center near Severance Town Center, the three-story, 79,000-square-foot hospital features large windows facing peaceful woods, muted blue hues, and communal dining areas I’m here.

This behavioral health hospital is designed to encourage patients to leave their rooms and join others to eat, watch TV or play basketball in the adjacent outdoor space. .

These activities teach people with mental disorders how to function independently regardless of their mental state.

“If you’re really depressed, you need a lot of energy to get out of bed,” says Julia Bruner, Ph.D., senior vice president of behavioral health and corrective medicine at MetroHealth. “Often, not only will you need medication, but you will also need an environment that helps encourage you to do so.”

The hospital has five units: geriatrics, dual diagnosis, mood disorders, thought disorders and adolescents. Group therapy and other programs address the specific needs of these various patient populations.

GeroPsych refers to delusions and other mental states that are exacerbated by dementia. A dual diagnostic unit treats patients with mental health conditions and substance abuse disorders. People with thought disorders have hallucinations and delusions, and mood disorders are accompanied by depression and anxiety.

The facility is designed with patient safety in mind. Door handles, faucets, and shower heads are designed to prevent tying ropes. The bathroom door is made of foam and attached to the wall with Velcro, allowing caregivers to quickly remove the door to gain access to patients in distress.

This is not a lockdown facility. Most patients are voluntarily hospitalized. In addition, for 15% of patients, hospitalization is required due to the risk of self-harm, he said, Bruner said.

To save money, the emergency department at Cleveland Heights Medical Center has been converted to accommodate a psychiatric emergency room. A shared emergency department connects medical centers and behavioral health hospitals.

The new hospital will receive patients from other Northeast Ohio MetroHealth locations, community hospitals, and community behavioral health organizations. Family and friends can also take their loved one to the Cleveland Heights Hospital Psychiatric Emergency Room for an evaluation.

“I am absolutely thrilled,” said MetroHealth’s Bruner. “It’s going to be phenomenal for our community.”