Cost concerns and a shortage of psychiatrists will force the closure of the last vestiges of Lawrence Memorial Hospital's mental health unit.
The shutdown will mean some senior citizens will be forced to seek treatment in hospitals in Topeka or Kansas City or, in some cases, one of the state-owned mental institutions.
LMH trustees Wednesday agreed to close the facility May 1 after learning only one psychiatrist was available to staff the unit. Hospital officials said that meant the physician would have to be on call 24 hours a day -- an impracticality.
"We're really helpless if we have only one psychiatrist to rely on," said Gene Meyer, LMH president and chief executive.
Since September the unit has been accepting only patients 65 and older. Before, the unit accepted all ages, but hospital officials changed the admissions policy based on staffing and cost concerns.
The idea that senior citizens will have to go out of town for some mental health treatments bothers some advocates.
"One of the definite concerns is that if you tell someone they need to go to Topeka or some other facility, they may be less willing to do that," said Ken McRae, a board member of the Bert Nash Community Mental Health Center. "It is difficult enough for people to seek mental health treatment. Any impediment that you add just makes that worse."
Meyer said LMH would try to minimize the effect on the community by creating a mental health consultation/liaison service that would provide mental health treatment to patients admitted to the hospital for other health needs but also required some treatment for mental health issues.
The mental health unit has been serving about four patients per day through the first three months of this year. Hospital officials said the unit needed five to six patients per day to be financially feasible. If the unit were to remain open, hospital officials projected it would lose about $7,500 in 2005, with the loss growing to about $330,000 in 2008.
The shortage of psychiatrists has been caused largely by the resignation of psychiatrists at Bert Nash. Their departure in September led to the decision by LMH to serve only patients 65 or older in the unit. Another psychiatrist's resignation in March factored into the decision to close the unit.
The psychiatrists have been replaced, but Meyer said most of the replacements are interested in providing only out-patient treatment because the state's reimbursement system makes that a more lucrative practice.
"It is economics," Meyer said. "Their practices benefit more from seeing patients in their office than in the hospital."
Trustees voted unanimously to close the unit, but several members expressed concern. Board member Dave Corliss questioned whether there was an effective plan in place by the hospital and Bert Nash to recruit psychiatrists to the area who would provide in-patient care.
"My concern is that we'll point to Bert Nash, and they'll point to us, and nobody will actually get an in-patient psychiatrist to this community," Corliss said.
The board agreed to seek a meeting this summer with Bert Nash officials to discuss the issue.