CLEVELAND, Ohio — The ADAMHS Board of Cuyahoga County voted today to provide $4.4 million to keep the St. Vincent Charity Medical Center psychiatric emergency department open in 2023.
Without the funding, St. Vincent’s psychiatric emergency department-- the only emergency department specifically for patients having mental health crises in Cuyahoga County — would have closed in November, when the hospital ends inpatient, surgical and emergency room care.
MetroHealth System also announced plans to add a psychiatric emergency department to its recently opened $42 million, 112-bed MetroHealth Cleveland Heights Behavioral Health Hospital.
MetroHealth has asked the Alcohol, Drug Addiction and Mental Health Services of Cuyahoga County board for $3.6 million to create a psychiatric emergency department as part of the new Cleveland Heights hospital that would open in January, said Dr. Julia Bruner, MetroHealth senior vice president for behavioral health and correctional medicine.
Since the announcement of St. Vincent’s closure, MetroHealth System — which is a safety net hospital like St. Vincent — has seen an increase in psychiatric patients, Bruner said.
“MetroHealth has been most responsible for caring for those (former St. Vincent) patients,” Bruner said. If the ADAMHS board turns down MetroHealth’s request for funds, “we will make it happen,” she said.
The ADAMHS board’s unanimous vote approving money for St. Vincent is an attempt to meet the critical need for psychiatric hospital beds in the region, mental health experts said.
Cuyahoga County is on track to have a record number of fatal overdoses this year, and the COVID-19 pandemic increased demand for mental health counseling. Nearly 5 million people visited emergency departments with mental, behavioral and neurodevelopmental disorders in 2018, according to the U.S. Centers for Disease Control and Prevention.
Cuyahoga County has 220 fewer beds than needed to fully meet residents’ need, according to national guidelines cited by MetroHealth. Economic pressures and a lack of staff contribute to the undersupply, health experts say.
St. Vincent’s psychiatric emergency department is one of two dedicated psychiatric emergency departments in the state, ADAMHS said.
The hospital has the funds to keep its psychiatric emergency department open through the end of the year, with its current $3.7 million ADAMHS grant, the board said.
The ADAMHS board will work on ways to secure funding beyond 2023, said ADAMHS board CEO Scott Osiecki. “Give us time to figure out what to do the following year,” he said.
Among the approximately 50 people who attended the emergency meeting, the mood was cautiously upbeat after the vote. Some people questioned what will happen when patients who come to St. Vincent’s psychiatric emergency department need to be hospitalized, since St. Vincent will have no inpatient beds after Nov. 15.
“On the one hand, I’m relieved. On the other hand, so many questions remain,” said Rosie Palfy, a member of the city of Cleveland mental health response advisory committee, which works to build relationships between the city and the behavioral health community.
Cleveland city councilman Charles Slife, vice-chair of the Health, Human Services and the Arts Committee, called the St. Vincent closure “a shock to the neighborhood.”
The Cleveland Heights behavioral health hospital “might as well be in Siberia for people on the West Side,” Slife said. “Many lives are going to be affected by this.”
Last month, St. Vincent announced that it would close its psychiatric and medical emergency rooms, inpatient care and surgical care on Nov. 15. This included the loss of inpatient beds in the psychiatric unit, as well residential treatment and inpatient detox beds in Rosary Hall.
St. Vincent currently has 20 inpatient psychiatric beds and 15 detox beds, and served nearly 1,000 psychiatric inpatients in 2021, the hospital said.
St. Vincent’s psychiatric emergency department offers crisis stabilization, 23-hour observation, assessment, and discharge planning. Patients have access to a psychiatrist or licensed practitioner around the clock.
The facility has safety features such as non-movable furniture and metal detectors, and offers 24/7 access, “which is critical for the patient population being served,” according to the ADAMHS board.
In 2021, there were more than 3,000 visits to the St. Vincent psychiatric emergency department, Osiecki said. About 25% of those patients required hospitalization.