Proposed closure of inpatient unit at Taunton State Hospital reflects statewide vision for mental he

[unhappycamper]

http://www.tauntongazette.com/article/20140126/NEWS/140127051/1994/NEWS

&MaxW=650

Proposed closure of inpatient unit at Taunton State Hospital reflects statewide vision for mental health services

TAUNTON — The state’s plan to close the inpatient unit at Taunton State Hospital reflects a philosophical shift that emphasizes community-based services over institutional care, a mental health official said Friday.

“When I started in the field, recovery wasn’t something anyone talked about. It was symptom management,” Department of Mental Health Deputy Commissioner Clifford Robinson said. “People tend to recover and rehabilitate better in a non-institutional setting, like the community. In the past 30 years there have been massive changes, and we think there are an awful lot of exciting possibilities out there.”

For the third straight year, the state is proposing to move all inpatient beds from Taunton State Hospital to the new Worcester Recovery Center. In each of the past two years, the state faced staunch local opposition. As a compromise struck in the Legislature, 45 beds currently remain at Taunton State, which used to have approximately 170.

Many local legislators, including state Sen. Marc Pacheco, D-Taunton, House Speaker Pro Tempore Patricia Haddad, D-Somerset, and Rep. Shaunna O’Connell, R-Taunton, have said they plan to fight the state’s plans again.

[MADem]

1. I think this nurse has a point....

In a statement released Wednesday, the Massachusetts Nurses Association called the move an “abandonment of the mentally ill.”
Longtime Taunton State Hospital nurse Karen Coughlin said there are some patients who require care that can only be administered in an inpatient setting.
“We always want to have patients be able to receive services in a community no matter what the level of care is,” she said. “I understand there’s a community first movement, but it’s not a community only.”
- See more at: http://www.tauntongazette.com/article/20140126/NEWS/140127051/1994/NEWS/?tag=2#sthash.3SRXzPIh.dpuf

[Live and Learn]

2. As does Clifford:

Clifford said he recognizes challenges associated with implementing the plan.

“We agree that there will always be some number of clients who require a continuous care bed in a hospital,” he said. “We would like folks who need that level of care to get that level of care in the best possible hospital.”

He lauded the quality of care provided by staff throughout Massachusetts, including at Taunton State Hospital, but said the new Worcester Recovery Center was designed and physically built around the modern approach to care. The architectural design, he said, promotes recovery and a return to independent living.

- See more at: http://www.tauntongazette.com/article/20140126/NEWS/140127051/1994/NEWS/?tag=2#sthash.ZM0S5ven.dpuf

Why should the mentally ill needing 24 hour care be any different than the otherwise physically ill?

We have tried the institutional care and it didn't work well, Why not give this an attempt?

[MADem]

5. Well, we do this already to a great extent in the Commonwealth.

I have a few relatives who work in those community-based homes. You do realize there's no "care" available around the clock; there's one guy or gal who can call 911 and who doles out meds, breaks up fights, encourages "group" behavior like preparing meals together and picking up the common areas, but it's not like there's a crew of psychiatrists on duty for these folks.

My concern is that beds for the seriously mentally ill are in short supply; and some patients can't wait a day or two--like that kid who stabbed his father down in VA, who did so after being turned away because there were no doggone beds. I saw this happen with a friend of one of my family members who wasn't violent, but who needed admission due to ongoing depression and a danger of self-harm--we ended up taking turns "babysitting" the guy for three days (and I barely knew him, and frankly, had other things to do that went undone) because we didn't want his death on our hands. The guy had no family to give a crap about him and he was in a bad way--nevertheless, it's not really a good idea to depend on the kindness of near-strangers because there's not an available bed. I just think they need to assess carefully before they start getting rid of beds wholesale. It's way easier to dump 'em than get 'em back.

This newspaper article leaves the impression that community based care doesn't exist--nothing could be further from the truth. It does exist, the Mental Health department did a big long study to determine efficacy, and aside from that there are a number of private actors in the mix as well-- and a lot of this inventory is CONTRACTED out by the state--private, sometimes for profit companies housing the mentally ill and intellectually disabled in home-based care situations. These people, though, have already gone through the institutional process and are stabilized on their medications.

Sampler:

http://www.advocatesinc.org/index.php

http://www.wildacreinns.com/

http://www.windhorseimh.org/

http://www.austenriggs.org/

The private models have halfway decent reputations, the DMH forays into group homes for the mentally ill haven't all been sunshine and roses--they've had problems: http://www.wbur.org/2012/12/18/massachusetts-group-homes

Even with that, I don't object to group homes at all--I just think they need to be careful how they expand the existing program, and avoid problems that they had when they first started this effort.

[pipoman]

3. an extension of raygun's defunding of mental health services

Making it more difficult for people who need immediate care to receive the care they need.

[madrchsod]

4. my wife works for a community based company.

the community based systems has unique problems and is not a cure all. it is a step in the right direction but the same bureaucracy restricts the mission.