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Guest Opinion: Mental health care in crisis Jackson County will hire a recruitment firm to hunt for mental health workers. Mail Tribune / Jamie Lusch Sunday Feb 26, 2017 at 12:01 AM By Susan Johnson I am a registered nurse and have worked for Asante for 13 years. Currently, I work in the Behavioral Health Unit (2North) with 18 beds. BHU offers in-patient care for adults in an acute psychiatric crisis. I also work in the emergency Psychiatric Care Unit (PCU) which is part of the emergency care team. We see all ages, genders and socioeconomic levels; our mission is to assess and determine the best care plan necessary for the patient. I was alarmed and angry when I read the Jan. 26 article “Health Care Jackson County — 200 to lose jobs” about AllCare canceling its contract with Jackson County Mental Health. This also comes on the heels of Jackson Care Connect discontinuing its contract with JCMH in December and switching its contracts to Columbia Care. To give a little perspective on this problem, the mental health crisis reached epidemic proportions approximately three and a half to four years ago and continues to inundate (and overwhelm) our resources across the nation. Just in our hospital alone, during the past four years, PCU nurses saw our usual patient load go from three to four patients a day to 20 a day. It was not unusual for us to take over half the emergency department with our population of patients in a mental health crisis. It is not clearly understood why this phenomenon occurred; all we knew was that we nurses were being buried under the need. Part of our procedure is to call in a crisis worker from Jackson County Mental Health to help with the patient assessment; however, JCMH was also overwhelmed. They had crisis team workers available 24 hours a day, seven days a week. However, there would be only one worker after 5 p.m. and on weekends, and these crisis workers also had to run the Crisis Hotline at the same time. As such, we sometimes had to wait hours for a consult from JCMH because they were so buried in crisis calls. To try to cope, the Jackson County Mental Health and Rogue Regional Medical Center teamed up to try and handle the tidal wave. The goal is to try and get our patients who arrive to the PCU assessed and either discharged home or, if necessary, hospitalized. If there wasn’t a bed available in our Behavioral Health Unit, the patient would be sent to another psychiatric care facility. The problem, though, was that every other facility was overwhelmed with psych patients. There have been times patients had to “board” or stay in our emergency room for extended lengths of time. However, with the new contracts from AllCare and Jackson Care Connect, Jackson County Mental Health was able to rise and meet the needs of the community. They were able to have crisis workers more readily available; they had more services to offer so patients didn’t end up in crisis and in the emergency room. However, once a patient is in the emergency room, JCMH, along with the psychiatric nurse and emergency physician, assesses and determines if patients need to be sent home, hospitalized, or if they can be sent to another, less acute, facility. These crisis workers also have a lot of resources in their tool belt. With their help, we are able to assess and move patients to a more therapeutic environment more quickly, thus clearing the emergency room for medical patients and lessening the wait and the need to have patients backed up in the hallways. Where was Options for Southern Oregon in all of this? Not available after 5 p.m. or on weekends. Even though we received patients from all over Josephine County, Options gave minimal help, even during business hours. We’ve even had Jackson County workers assess the Josephine County patients as a courtesy to us and to help the patient receive the care needed for their recovery; this also expedited movement of patients out of the emergency room. In short, Jackson County Mental Health recognized the need and bulked up to meet it. JCMH recruited from all over the country to meet this critical need. They have always been there for the PCU and have been working particularly hard the past three years to help our patients receive the necessary care. Jackson County Mental Health workers have earned every bit of the alloted $13 million awarded to them from Jackson Care Connect and AllCare. Now, Karla McCafferty, the executive director of Options, says they can do it for $8 million. McCafferty was quoted as saying, “(we) do similar services so we know what it should cost” and she is “envisioning … having health care in places where people already naturally go, like doctors’ offices, pediatricians’ offices and schools. It is about having mental health care where people are going and where they are already comfortable going.” Options has not been in the trenches dealing with this crisis. JCMH has. It is a known fact in the community of Southern Oregon that Jackson County has more services to offer our patients. McCafferty apparently doesn't know that our patients who are in a mental health crisis most often don’t go to the doctor, pediatrician or school. Our patients and their families are usually in crisis because of a lack of funds, a lack of support for the family, and/or lack of insurance that, in turn, exacerbates mental illness. Most of our patient population is delivered to the hospital by family or friends, or brought to the hospital by the police. Jackson County has increased personnel to try to meet this need before it becomes more of a crisis. JCMH has already partnered with our schools, elementary through college, to keep them in the loop about any student that has been seen in our facility for a mental health crisis. If McCafferty had been more involved, she  would already know this. If she cared enough, she would have reached out to us. It’s safe to say I’m skeptical of Options taking over this care because I haven’t seen a good-faith effort on the part of Options until they saw there was money to be made. The community will be the losers in this deal if Options takes over and runs this program the same way they have for the past five years: ”Sorry, we are closed." — Susan Johnson of Medford is a registered nurse and a behavioral health nurse. The opinions expressed in this piece are her own, and do not necessarily reflect the opinions of Asante or Rogue Regional Medical Center.