NEW YORK NURSE: July/August 2011
by Mark Genovese
NYSNA members at Westchester Medical Center believe the planned closing of the hospital’s Comprehensive Psychiatric Emergency Program (CPEP) could cause more suffering than savings.
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 other hospitals. Many times, these beds house adolescents that other facilities aren’t equipped to handle.
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. NYSNA 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 accepts patients from police departments 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. Closing the CPEP would leave the assessment center 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 former CPEP nurse Catherine Brand, who was reassigned last year after her 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?”