MRH moving to create Crisis Stabilization Unit for those in urgent need of mental, behavioral or substance use-related care

The sign above the entrance to the Emergency Department at Memorial Regional Health in Craig.
Cuyler Meade / Craig Press

When a patient arrives at the Memorial Regional Health emergency room with a traumatic injury or other emergency medical issues, that patient can typically be treated, transported if necessary and eventually released having received care and direction necessary to get healthy.

But if the emergency medical care that a patient needs is related to thoughts, addictions or other breakdowns that are occurring in his or her brain, MRH — as much as staff might want to help — can only do so much.

Combined, mental health concerns, behavioral health issues and substance-use disorder bring close to 1,000 patients a year into the MRH emergency department. The ER is not equipped to care for these patients on anything other than immediate, extremely short-term stabilization, and there’s nowhere for an individual undergoing a mental or behavioral health crisis to stay and receive somewhat more focused care. There’s no resources for someone in the throes of an addiction situation to be evaluated and treated for more than a few hours.

MRH intends to change that. By the end of 2022, the hospital expects to have a Crisis Stabilization Unit (CSU) operational, creating a space for patients with these sorts of needs to be cared for over a number of days while future long-term treatment options are evaluated.

“One of the big focuses the hospital is looking at is how do we provide mental health and behavioral health services locally?” said Kyle Miller, MRH Vice President of Clinical Support Services. “How do we bridge the gap between outpatient and inpatient services they might need? The mindset of a Crisis Stabilization Unit is basically a unit that’s a temporary treatment service for patients seen in the E.R., and we’re trying to find either an inpatient bed for longer term or referring them to a more long-term, intensive outpatient program.”

The conversation, Miller said, has been brewing since last summer.

“We knew a gap was here locally and regionally,” he said. “We’re trying to address that.”

The plan is to install the CSU in the place of the soon-to-be-former COVID-19 ward, which itself was in the former obstetrics wing. COVID-19 care will take place in newly outfitted rooms that can be switched to negative pressure in order to diminish the chance of viral spread to providers.

Miller said this isn’t a reinvention of the wheel — the CSU model exists in many hospitals, most particularly those in rural areas.

“Western Slope and regionally, you’ll see this impact on rural areas because you’re taking the burden off the ER,” Miller said. “Those are probably already stressed with traumas, heart attacks, other major medical issues, and where do you get these patients? You know, you discharge them and the chances they get into outpatient treatment is low. So if we can put you with like diagnoses, get you in touch with peer support specialists, get you through treatment resources and find a final place — inpatient or outpatient, as they need.”

The plan requires adding staff, starting with a program director who could potentially be a psychiatrist or psychologist, Miller said. Oversight by a medical professional could suffice if a non-medical provider were right for the director role. Other personnel would include a dedicated nurse for the unit as well, and telehealth options are likely to play a role in the operations.

For MRH and its partners, this is a move to continue to not only provide care for the mind, but also diminish the stigma that can be a barrier that prevents someone suffering from getting that care.

“There’s a stigma for substance use, of course, but it relates to mental health and behavioral health care, too,” Miller said. “There’s a stigma that the mind is not healthcare. It is. Just like addiction recovery services is part of the model. It’s all healthcare. You have to treat it as such.”

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