In the midst of a statewide mental health crisis, Boston Medical Center is offering some relief, with plans to start admitting patients to an 82-bed behavioral health center in Brockton this October.
The facility, at the site of the former Braemoor Health Center nursing home, will have 56 acute inpatient psychiatric beds for patients 16 and older. Another 26 beds will be for patients 18 and older who need so-called step-down treatment for substance use disorder following detox or inpatient care.
The 64,000-square-foot facility will open as the number of opioid overdose deaths in the state also surged to an all-time high last year, according to state data.
Additionally, health systems have warned that their emergency departments and hospitals have been filling with patients who are unable to find an inpatient psychiatric bed, amid an unprecedented level of behavioral health patients coming to the emergency department. Last week, Massachusetts hospitals said they had almost 560 patients boarding in a hospital while awaiting a psychiatric inpatient bed.
Kate Walsh, CEO of Boston Medical Center Health System, said her hospital was not immune to those challenges, with patients also boarding in her hospital.
The push to open more psychiatric beds was additionally driven by the broader needs of BMC Health System, which includes the hospital and BMC’s insurer, WellSense Health Plan. Data showed that 25 percent of the system’s patients on the state’s Medicaid program who were discharged from a psychiatric facility returned to the hospital within 30 days.
“We know we can do better than that with the programming facility here,” Walsh said.
Walsh added that the facility would take patients with substance-use disorders and other mental health disorders, who often have difficulty finding placements at treatment facilities or psychiatric hospitals.
Ryan Boxill, the chief behavioral health officer for BMC Health System, said the program would be unique in treating substance use disorders with other mental health disorders and physical ailments in one place.
“We recognize that substance use disorder is a mental health disorder. You can’t appropriately treat or effectively treat substance use disorder without having a conversation around other mental health disorders like PTSD.” Boxill said. “The benefit having a program based on an academic medicine model is we’re addressing their physical health and substance use disorder as well as their other mental health disorders.”
The program will also connect with the academic medical center, offering training for residents and fellows in many BMC programs.
The $41 million project was partially supported by a MassHealth incentive program, which has financially aided hospitals that open inpatient psychiatric beds this year. Additionally, the state Legislature provided $12 million in state funding to redevelop the property and cover a significant portion of the project’s capital costs. The facility wouldn’t have been possible without the state support, Walsh said.
“When we put out a call for the development of additional psychiatric inpatient capacity, Boston Medical Center was one of the first hospitals to step up to the plate,” said Secretary of Health and Human Services Marylou Sudders, in a release. “Today, we see the fruits of that commitment.”
The project also received a $6 million donation from an anonymous donor, which helped renovate the facility to be net zero for carbon emissions from energy. Geothermal heating and cooling systems. combined with solar panels, will provide all of the facility’s power needs.
Danna Mauch, CEO of the Massachusetts Association for Mental Health, said the new beds would contribute to solving the state’s mental health crisis.
But new inpatient psychiatric beds, being created by health systems around the state, are only one component, Mauch said. The state still has to increase home and community based resources so patients can be discharged in a timely fashion from an inpatient bed. Patients also need community interventions before they are in crisis.
“I don’t think anyone would argue that these beds aren’t needed,” Mauch said. “In an ideal world, with a robust home- and community-based system that was fully operational and staffed, [we would] get upstream of the challenges people are having.”
The state also has a number of inpatient beds available that it cannot open because of staffing concerns, and it wasn’t clear whether BMC was hiring staff for the new facility from other beleaguered programs.
Boxill said while it was difficult to track where its staff might have been previously employed, the majority of those hired come from Brockton and the surrounding areas.A total of 175 full and part time employees will ultimately be hired for the facility.
While BMC has had success staffing up the operation, running it will still be a financial challenge. Despite significant state help — from both the capital commitment and higher reimbursements from the state’s Medicaid program for their work — reimbursements for psychiatric care are still much lower than those for medical issues.
Yet addressing the behavioral health of its patients is critical given the needs of a large portion of the system’s patients and members, Boxill said. Of members insured by BMC’s WellSense Health Plan and patients at BMC combined, nearly half have a behavioral health diagnosis, driving 80 percent of the health system’s health care spending.
Walsh put the reasons for the investment succinctly. “It is what our patients need.”