West Springs psychiatric hospital expansion serves growing mental health need | AspenTimes.com

West Springs psychiatric hospital expansion serves growing mental health need

Tatiana Flowers
Glenwood Springs Post Independent

The only psychiatric hospital on Colorado's Western Slope will soon expand its premises and its services.

West Springs Hospital is the only psychiatric hospital between Denver and Salt Lake City, offering treatment all the way north to the Wyoming state line and south to the New Mexico line.

"We are covering 500,000 people with a 32-bed capacity," said Dr. Frank Lotrich, the medical director at the hospital located in Grand Junction. "In addition to that, we live in an area where there are a lot of suicides, along with untreated mental health."

According to the U.S. Census Bureau, about 62,000 people live in Grand Junction alone, and hospital officials say there's anywhere from three to 22 people waiting for a bed every day.

"For many people, their psychiatric illness develops to an extent that it is too unsafe to treat them outside of a hospital," Dr. Lotrich said.

"If something is not done quickly or in a supervised setting, there is the fear that something bad will happen, sometimes death."

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The hospital's expansion, which is slated for completion in mid-December, will include 32 more beds (totaling 64) and additional dining, activity, exercise and recreational spaces.

The expansion will include longer visiting hours, a new kitchen, and a designated 16-bed child and adolescent unit.

The goal is to hire 25 additional staff members within the next five years, to address what health care professionals are calling an "upswing in the volume of psychiatric emergencies."

"We designed this building to double in size and accommodate the psychiatric need and growing populations," said Sharon Raggio, CEO of the hospital and its sister organization, Mind Springs Health, which has a base in Glenwood Springs. "It may be that we hire all 25 new staff in three years instead of five years. We'll just (have to) see how many people use the hospital."

With the hospital's current waiting list and rising suicide rates — both locally and nationally — hasty staff expansion is probable.

front lines

Local officials in other health sectors and law enforcement say they're increasingly stepping into a mental health-related role to alleviate increased need, even though it's outside of their expertise.

"I want people to bring their loved ones here but we're in crisis, too," said Dr. Ben Peery, medical director for the emergency department at Valley View Hospital in Glenwood Springs.

"We're not a psychiatric institution, but we're taking this on because it's the right thing to do," he added. Valley View Hospital has a partnership with Mind Springs Health.

If a psychotic individual comes to the hospital's general emergency department, a crisis intervention team from Mind Springs will transport them to the psychiatric hospital, or offer outpatient services, Peery said.

Peery and other health care professionals say general or acute care hospitals aren't equipped to handle psychiatric crises.

"One, by regulation, a psychiatric hospital has to be locked," Raggio said.

Most hospitals don't have locked units or professionals who are trained to treat mental health-related issues on a daily basis, she said.

Hardware is safeguarded in psychiatric hospitals to eliminate the potential for self-harm, and in acute care hospitals that's not the case, she said.

But Peery and others on the Western Slope will likely continue treating people with acute psychosis, given limited resources for a rural community and only one regional psychiatric hospital.

"It's almost overwhelming for Valley View at times because we could be watching three or four patients at once that require one-on-one supervision," Peery said.

When people seek help at his general hospital, they're usually suicidal and often times the person is transported there by EMS or local law enforcement.

"The average deputy on the street will be dealing with a person with mental illness on a regular basis," said Garfield County Sheriff Lou Vallario.

"What it does is it puts us into a field that we're not experts in. It makes it more difficult for the cop on the street because it's out of his training or expertise," he said.

Garfield County Jail commanders typically oversee "everything from substance abuse, detoxing, folks who are bipolar, schizophrenic, the whole gamut of mental health disorders," Vallario said.

On average, people with mental illness typically remain in jail four times longer than people without mental health issues, Vallario said.

Competency hearings and evaluations add to the person's sentence, he said. "These folks, again, are almost having two strikes against them."

A few of his deputies are certified in Crisis Intervention Team training, a course that teaches police how to help individuals with mental illness, instead of placing them into custody because of their mental health status.

But Vallario said it has proven difficult to train the entire team, because classes run 40 hours a week and are held in different locations.

To pull officers off the street, where they're needed most, has proven difficult, he added.

inadequate training

Lindsay Steel says she has had mental health-related run-ins with Garfield County Sheriff's deputies, and questions why there's not better training.

One day, she said she had been driving her daughter to school when her daughter experienced psychosis. Steele said she felt unsafe, so she asked her daughter to exit the vehicle and walk the rest of the way to school.

It was below 20 degrees outside when Steele got the call from a sheriff's deputy who said he was planning to press charges against her.

Steele says the officer wouldn't listen when she tried to explain her daughter's mental health status. She says when she asked him to call her daughter's psychiatrist for background, he wouldn't agree.

"I'm not sure how he didn't notice, but still treated me as if I was parenting wrong," Steele said.

"He should have been trained to identify mental illness and approach the situation differently," she said.

That same morning, Steele's husband visited the high school and met with the deputy. Soon after, the issue was resolved and the officer decided not to press charges, she said.

The new psychiatric hospital offers a variety of services. The primary goal is to manage medications properly, hospital staff said.

"We can change and fix medications much more quickly than in an outpatient setting," said Dr. Lotrich.

The second important element of treatment is family, group and individual therapy, he added, and the third is coordination of outpatient services.

"People aren't cured by the time they leave and they usually require ongoing outpatient treatment," Dr. Lotrich said.

That's one misconception people have about psychiatric hospitals. The other is that patients stay in the facility for an extended period of time.

That's not true, he said. The average length of stay is seven days, he and Raggio said.

Each morning, Lotrich meets with hospital staff to review patient referrals. He says all referrals are appropriate for that level of care. "But we're unable to meet them all," he said.

Patients are sent to Denver or Colorado Springs when West Springs is full, Lotrich said.

Some counties will decide to keep the individual if they can find creative ways to keep the person safe outside of a hospital, he said.

"Some patients in jail, just have to remain in jail," he said. "And, as bad as it is, it may be safe inside the jail."

According to the Treatment Advocacy Center, "In 44 states, a jail or prison holds more mentally ill individuals than the largest remaining state psychiatric hospital."

To add, Colorado lags far behind most other states when it comes to emergency services.

In 2008, there were 11.8 psychiatric beds per 100,000 people in Colorado, while the national average was 29.9.

In 2014, Colorado's number of beds fell from 11.8 to 5.5 per 100,000, according to the American College of Emergency Physicians.

The state is generally ranked below a C for access to emergency services, according to the American College of Emergency Physicians.

Peery, from Valley View Hospital, is working with local leaders like Glenwood Springs Police Chief Terry Wilson and District Attorney Jeff Cheney to explore possibilities for further resource expansion.

Peery suggests a new detox center to help people remain sober, because drugs are contributing to "psychiatric frailty," he said.

His theory is that people are managing their mental illnesses with substances.

Steele said it took her three months to finally get her daughter an appointment at Mind Springs Health in Glenwood Springs.

Staff kept rescheduling appointments, would rarely return her phone calls, and there would be long wait times when she would visit the facility, Steele claimed.

Dr. Liotrich, the medical director at West Springs Hospital says he's sadly not surprised by Steele's statements.

"The amount of unmet need out there is tremendous," he said. "We're trying to maintain some level of quality," he added.

His hope with the hospital's expansion is that suicide rates will decrease, quality of life will improve and that, overall, there will be decreased suffering, he said.

In response to Steele's comment, he said, "It's an area we realize we need to fix and it is getting better, but we have a long ways to go."