October 3, 2022

Mental-health crisis demands urgent House action

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What’s behind the interminable time it takes to get anything done on Beacon Hill?

Is it because lawmakers’ deliberations and bloviations occur in a vacuum, far removed from the source of the real-life issues before them?

This State House isolation might lend itself to a detached, deliberate analysis of matters based solely on their merits, but without the urgency some decisions demand.

Case in point – the cascading behavioral-health crisis that’s overwhelmed this state’s medical community.

It’s been almost seven months since the Senate unanimously approved a wide-ranging behavioral-health bill.

One of its key provisions would address what’s known as emergency department boarding or “ED boarding.” That’s when those in the throes of a mental-health crisis seek help in a hospital emergency department.

Waiting to be admitted to an inpatient psychiatric unit can take days or weeks. In the interim, those seeking help remain in the emergency department, receiving little or no psychiatric care.

The bill would create an online portal with real-time data to help providers more easily search for open beds. It would also require hospital emergency departments to have a qualified behavioral-health clinician to evaluate patients during all operating hours.

In late November that bill moved to the House Ways and Means Committee, where it’s languished ever since.

In the meantime, the state’s health-care system has been inundated with individuals in need of the resources this legislation would provide.

A snapshot of this exponentially growing demand-supply gap came via a recent Boston Globe article.

It indicated that on Monday, nearly all of South Shore Hospital’s pediatric emergency beds were occupied by suicidal children.

The 10 patients, some of whom were left stranded there for 12 days or more, await a facility to care for their mental-health needs. Another 18 adults were in the emergency department with behavioral-health issues, also waiting for beds.

This isn’t an isolated scenario, but rather a worrisome trend.

Hospital officials throughout the commonwealth face unprecedented numbers of critically needy behavioral-health patients; it’s a major contributor to emergency room crowding that’s soared in recent weeks.

According to data compiled by the Massachusetts Health and Hospital Association, one hospital on May 2 had all its staffed emergency department beds occupied by patients awaiting a psychiatric evaluation or placement at a facility.

The 557 patients boarding in emergency departments at state hospitals on May 16 — another high-water mark – also speaks to the scope of this crisis.

In addition to flooding emergency rooms, this behavioral-health spike has forced some patients – those boarders that the Senate bill addresses – to occupy beds on regular hospital floors while waiting for the in-patient psychiatric care, sometimes for weeks or even months.

Unlike COVID-19 surges, which seem to vary with new variants, officials say surges of behavioral-health patients in emergency rooms haven’t receded.

While COVID-19 didn’t create this massive behavioral health- services backup, it’s certainly made a bad situation worse.

Apparently in no rush to expedite enactment of this vital legislation, Speaker Ron Mariano in March disclosed that the House intended to pursue its own mental-health bill during the remainder of the legislative session, an enhancement to the behavioral health-care reforms passed months ago by the Senate. Mariano said the House and Senate should ultimately be able to merge their respective bills to galvanize “a real comprehensive change in how we deal with mental health.”

Take your time, Mr. Speaker; those countless mental-health patients seeking services and overwhelmed medical centers can wait.



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