Suicidal often wait days in ERs before treatment

Several times a week, people arrive at a Middle Georgia hospital so sick and distraught that they’re planning to kill themselves or hurt someone else. Having the worst time of their life, they’ll sit in an emergency room for perhaps two days straight before getting treatment in a state mental hospital.

That’s the reality described by local health workers who say the region’s mental health system has been straining since Central State Hospital in Milledgeville made drastic cuts in service early this year.

Dr. Delanor Doyle, medical director of the emergency department at The Medical Center of Central Georgia, said days-long waits are typical but have gotten better.

“We’ve had people here for 92 and 98 hours. Now it is unusual to have people here for 72 hours,” Doyle said.

Since December, Georgia has lost a total of 134 mental hospital beds, 96 of them at Central State. Since then, the state has added another 12 beds statewide — all in the River Edge crisis stabilization facility in Macon, where the adult beds were converted from a children’s unit that itself opened in the past year.

Tom Wilson, a spokesman for the Georgia Department of Behavioral Health and Developmental Disabilities, said that in the next month the state will open another 10 beds at an Augusta mental hospital that serves most of Middle Georgia, as well as another 22 beds at a Columbus mental hospital.

Wilson said the state is working to shift more services into communities, and the federal Department of Justice, which is supervising the state’s mental health care, wants to close all the traditional mental hospital beds.

“We are responding to some of the concerns about wait times, but the solution is not going to be us adding more hospital beds,” Wilson said.

The state’s figures show significantly shorter delays. Wilson said people may be spending more time in emergency rooms than the state data show, but they could be getting treated for physical problems before they call a state hot line for a mental hospital bed.

The state mental hospitals are intended for the most critical patients. Coliseum Psychiatric Center CEO Jim Eyler said the state has missed a middle ground by keeping dozens of beds open at Central State.

“I don’t think anyone wants to go back to the ’70s when Central State had 12,500 inpatients,” he said. “And now they have none.”

The shift to Augusta also means deputies who normally drive the mental patients don’t drive nearly as often, Eyler said. Bibb County deputies could make two trips to Central State in three hours, but one trip to Augusta takes five hours.

“Before Central State closed, it was probably a five- or six-hour wait just in terms of transport. Now it’s 12 to 24 hours most times,” he said.

Coliseum Psychiatric Center often has 18 or 19 of its 20 beds full, leaving it little room to maneuver.

Even with the addition of 12 adult beds to make a 28-bed adult crisis stabilization unit, River Edge Behavioral Health Center CEO Shannon Harvey expects to stay busy.

“Generally speaking, we’re going to stay full,” she said.

On the Friday before Labor Day, River Edge administrators and staff learned in the morning they were authorized to open a dozen new beds. Five hours later, the unit was staffed and running.

Bibb County Sheriff Jerry Modena said his deputies are typically taking four or five mental patients a week out of the county for more intensive treatment.

Modena said the county jail may be the largest mental health facility around, typically with about 200 people with only mental illness, rather than mental illness mixed with drug or other problems. That’s 10 times the number of beds at the Coliseum Psychiatric Center.

Modena said county residents are paying to treat the mentally ill in jail, which is a bad situation for everyone. Without the jail’s treatment, more mentally ill people would be getting so sick they’d need to be sent to the state mental hospitals or the crisis stabilization units, he said.

“Mentally ill people are ill. They’re not criminals, not somebody who’s just a bad person. They’re ill. They’re sick,” Modena said. “Instead of taking care of them, with beds more toward treatment, it’s a jail cell toward punishment. It don’t seem right.”

Health official say they’re working to improve the process. the Medical Center is getting psychiatric staff to make rounds through the emergency room, Doyle said.

Wilson said the state is trying to better coordinate things, to let referring doctors know where the vacancies are. There’s also work to make sure paperwork delays aren’t holding up patients.

Wilson said some of the delays come from simply getting mental patients stabilized physically. Many mental patients also have other health problems, especially drug problems. River Edge also launched a team that visits patients at home to make sure they’re being properly treated.

Harvey said no one is really at fault, but problems in the system mean more pain for people who are already struggling. She tries to describe what long waits can mean, and transportation to the mental hospital in Augusta.

“People come to us suicidal,” she said. “They wait 8 hours. Then it’s a 2 1/2-hour drive. I say to my staff, if you weren’t suicidal before, you are now.”

To contact writer Mike Stucka, call 744-4251.

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