Westchester Med psychiatric emergency services too important to lose, RNs say

VALHALLA, June 28, 2011 – The planned closing of Westchester Medical Center’s Comprehensive Psychiatric Emergency Program (CPEP) could cause more suffering than savings, according to the union that represents the medical center’s 1,600 registered nurses.

The New York State Nurses Association said that, based on the experience of communities elsewhere in the nation, closing such emergency mental health services can increase the burden and expense on general emergency rooms and correctional facilities.

The medical center has petitioned the New York State Office of Mental Health to lower the unit’s status from a CPEP to an assessment center, dissolving its Mobile Crisis Team and closing the unit’s six extended observation beds. Nurses say this will discontinue a full range of psychiatric care for the community’s most severely mentally ill.

The unit is used for adult and adolescent patients waiting for a bed on the inpatient units, further evaluation and referral to outpatient services, or transfer to others hospitals. Many times, these beds house adolescents that other facilities aren’t equipped to handle. The Nurses Association believes the medical center’s plan to rely on just a hotline could increase the risk of violence against patients and staff at other area facilities, since the medical center’s psychiatric ER accepted patients from police departments from throughout the region.

Half of the unit’s nursing positions were eliminated last year, leaving just one RN to run the emergency room and the six-bed unit. The assessment center would be left without any RNs. “If there is no longer an RN in the ER/CPEP, who will evaluate and medicate violent or psychotic patients brought to the Behavioral Health Building by police agencies?” asked Catherine Brand, RN, who was reassigned last year after her CPEP position was eliminated. “Will they go to the main ER and be cared for by personnel who may not be trained in such specific de-escalation?”

“Have the administrators who made this decision spent time in the CPEP to see what we do?” Brand added. “Are they aware of what a valuable resource that Mobile Crisis Unit staff are?”According to the National Alliance on Mental Illness, two-thirds of states have cut funding for mental health care during the past three years. The result is a nationwide loss of $1.8 billion in mental health funding in less than three years, not counting Medicaid. Adding in Medicaid cuts will make the situation much worse.

The New York State Nurses Association is the voice for nursing in the Empire State. With more than 37,000 members, it is New York’s largest professional association and union for registered nurses.The association represents registered nurses, and some all-professional bargaining units, in New York and New Jersey. It supports nurses and nursing practice through education, research, legislative advocacy, and collective bargaining.

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