Denver Health plans to reopen 12 idled psychiatric beds on Monday, forming a new unit for people who need hospital-level care for mental and physical conditions at the same time.
Funding from the sales tax that Denver voters approved last year through Ballot Issue 2Q helped pay to renovate the unit, known as the Integrated Medical and Psychiatric Care Unit, or IMAP. Denver Health projected the sales tax would raise about $65 million, which it could use to support mental health and addiction treatment, emergency services and primary care.
With the 12 adult beds from the previously closed unit added in, Denver Health will have 57 beds for adult psychiatric treatment and 21 for teenagers, CEO Donna Lynne said.
“I thought it was just outrageous that we couldn’t open all the beds we have at Denver Health,” she said during a ribbon-cutting Friday morning. “The 2Q (sales tax) money is going to help us support these services.”
The unit is the first of its kind in Colorado, serving people who have mental health symptoms severe enough to warrant psychiatric hospitalization, but also have an unstable physical condition requiring hospital care. It can’t take people whose conditions are serious enough that they need an intensive care unit, though.
Psychiatric hospitals vary in the level of medical care they can provide, but most won’t take patients with another serious condition, said Dr. Bobbie Jo Dodson, the IMAP medical director.
For example, someone who had poorly controlled schizophrenia and dangerously high blood sugar normally would have to spend a few days on a regular medical unit to get their blood sugar under control before they could go to a unit set up for mental health treatment, she said.
“It makes sense that both illnesses can and do decompensate at the same time,” she said.
On a medical unit, psychiatric patients typically have to stay in their rooms, because they don’t have designated common areas and the hallways aren’t set up to prevent patients from hurting themselves or others, Dodson said. Also, while the nurses and technicians do their best, those working on a medical floor don’t have expertise in caring for patients who are seriously mentally ill, she said.
Frances Vaughn, a behavioral health technician who will work on the new unit, said she frequently sees patients who need to transfer between the medical and psychiatric floors. Having them stay in one place will reduce hassles for the patients and allow staff to work more efficiently, since they won’t have to send someone down to the medical floor to supervise the patient at all times.
“When they get to medical (units), they still have to have one-to-one” supervision, she said.
Denver Health designed the unit for safety, with furniture patients can’t lift and fixtures that bend if someone tries to use them as a ligature point, said Kimi McBryde, behavioral health project manager.
Patients who need medical equipment that they could use to harm themselves or others will still need one-to-one supervision during that part of their treatment, but the rooms have sliding doors that they can lock to make sure patients can’t hurt themselves with the outlets needed for that equipment when they aren’t using it, she said.
“When this (sliding door) is closed and locked, it’s just a psych room,” she said.
Patients might still need to transfer between units if, for example, their mental health stabilizes, but they aren’t physically healthy enough for discharge, Dodson said. Providers have discretion to determine if a transfer makes sense, or if a patient is close enough to discharge that they should stay in place a bit longer, she said.
The unit will stay busy because people with serious mental illnesses have more chronic conditions than those without major psychiatric conditions, said Dr. Chris Thurstone, chair of behavioral health at Denver Health. They have a life expectancy 15 years shorter than the general population, and early cardiovascular disease is one of the biggest contributors, he said.
“We’re going to stop having all these silos, and we’re going to integrate medical care the way it should be,” he said.
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