In St. Louis, protests against closing of ER at psychiatric center

From the St. Louis Post-Dispatch:

Mental health workers and advocates on April 16 protested state budget cuts that would close the emergency room at Metropolitan St. Louis Psychiatric Center in July.

"It's not worth it to hurt the most vulnerable residents of our state," said Christine Woody, a coordinator with the Missouri Association for Social Welfare.

The protest, held in front of the hospital at 5351 Delmar Boulevard, was organized in response to a state Senate committee's passage of a budget proposal from the Department of Mental Health that could eventually save the state $7 million a year.

A spokesman for the department was unavailable Friday to comment.

The cuts, if included in Missouri's final budget, would close the emergency rooms and short-term inpatient units at the Metropolitan Psychiatric Center and the Southeast Missouri Mental Health Center in Farmington.

There were 4,634 emergency room visits to the two hospitals last year. The typical acute psychiatric patient has a mental illness such as bipolar disorder or schizophrenia, comes to the facility in a crisis and is usually released within 10 days after adjustments to medications.

Eighty-eight beds at the hospitals would be converted to long-term care after an additional downsizing of the Fulton State Hospital to 300 psychiatric beds from 465. About 300 jobs would be lost in the process, although few would be in the St. Louis area.

Organizers of the protest said they worry that eliminating the emergency psychiatric care could lead to increases in homelessness, crime and overcrowding at area hospitals.

"There's no place for these people to go," said Rita Dongas of the American Federation of State, County and Municipal Employees. "They'll end up in the street and in jail."

The state has long been reducing its mental health services. At their peak in the 1950s, state psychiatric hospitals housed 13,000 patients, compared with the current 1,500.

The Department of Mental Health has attributed the reduction to a lack of federal reimbursements, state budget reductions and a nationwide movement away from institutionalizing patients.

Closing the emergency room would place additional burdens on the state's busiest emergency department, at Barnes-Jewish Hospital. The Central West End hospital has recorded record volumes this year and could reach crisis levels in the next few months, doctors say.

"We already run at capacity in the emergency department," said Dr. Rob Poirier, chief of emergency medicine. "Having another 3,000 or 4,000 patients, especially those with severe chronic or complex behavioral health issues, is going to be difficult."

Poirier said local health officials have been working on possible alternatives, including adding psychiatrists to the staffs at federally funded health clinics.