The entire unit, which already contained 17 beds for adult behavioral health patients, was completely renovated and 16 new geriatric patient beds are being added to complete the expansion project. The extra beds and 7,000 square feet of additional space, which cost $1.3 million, are especially crucial for Western North Carolina where behavioral health beds are scarce and the need is on the rise.
Marc Gerber, director of behavioral health services at HRMC, said no other hospitals west of Asheville offer a behavioral health unit. The lack of mental health beds is not just limited to this region — it’s a nationwide issue.
“You’re not going to find many communities in the U.S. where the need for psychiatric services is being met,” he said. “But we’d like to end up being a solution for the community and geriatric services was a logical choice because that service isn’t anywhere west of us.”
The new geriatric beds are specifically for anyone age 55 and older while the other 16 beds in the unit are for any adults 18 and older. Gerber said the renovations have made the unit safer with more measures to prevent self-harm and offers a brighter, more therapeutic surrounding.
With the region’s population aging quickly, it makes sense for HRMC to focus on providing more mental health services for that age group. According to the World Health Organization, 20 percent of adults 60 and older suffer from a mental or neuropsychiatric disorder. More are at risk of developing depression and anxiety as they deal with chronic pain, manage multiple prescriptions and cope with losing their independence.
Gerber said HRMC’s behavioral health unit can assist adult and geriatric patients with psychiatric evaluations and diagnosis, medication management, therapy and a healthy living plan for after they’re discharged. Misuse of medications is often why elderly patients may end up having a behavioral health crisis.
“In our older population we have to adjust their medication more gingerly because their livers and kidneys are not working as well as they were in their youth,” Gerber said.
Patients are often admitted to the unit from the emergency department or by a referral from a primary physician or another facility. Patients undergo an evaluation in the ER first to make sure they’re stabilized enough to be admitted. Then they are fully assessed by a mental health clinician, psychiatrist and the nursing staff; undergo individual and group counseling; and receive medications if needed.
“There’s daily communication between social workers and medical providers, and we work on putting together a plan to not just get you safely discharged but to succeed when they get out,” Gerber said. “They could go home from here or to a nursing facility. That’s some times the biggest challenge — finding a safe placement for them — which could extend their stay here.”
Gerber said the adult behavioral health unit was staying full long before he arrived to the job seven months ago. He said it’s rare to have a couple of beds that stay open for long with the average stay time between 14 and 16 days. He expects the same will happen when phase two of the geriatric expansion project is complete early next year.
“I think it will take probably take six months to get up to capacity. We’ll have some new practices and we don’t want to fill up in the first couple of weeks. We’ll want to make sure everything is running properly first,” he said. “The need is there, but we want to expand intelligently to make sure we have the resources in place before we open a complete unit.”
Payer source is not a consideration when looking to be admitted to the unit. While the average stay time is 14 to 16 days, there is no maximum time — it all depends on how quickly the patient can successfully be transferred to a lower level of care.
So far the unit is doing well, Gerber said, adding that recruitment is always a challenge in the behavioral health field. The unit currently has 45 employees on staff but will need to double that as the expansion is completed.
“Psychiatric services is not where new nurses think they’ll go — I know it never even crossed my mind — but I was looking for a challenge and I found one,” Gerber said. “If you look at the population we serve, here’s a group that needs advocates more than any other group out there.”
For more information, call 828.452.8655 or visit http://myhaywoodregional.com/services/behavioral-health-services.