Brockton-area providers strain to keep up with increased demand for mental health care

By Nidavirani (Own work), CC BY-SA 3.0 via Wikimedia Commons

By Anna Guaracao
Boston University Statehouse Program

Mental health-related visits in Brockton facilities have seen a steady increase since 2018, reflecting a statewide trend of more anxiety and stress in the national population, according to a recent state health care cost and policy analysis.

The Health Policy Commission met twice in the past week to review this recent increase and other trends as part of efforts to analyze rising health care costs.

The report states that the average number of therapy visits among Bay State residents, ages 18-64, went from about 12 in 2018 to over 15 in 2020. Individuals seeing a therapist at least once a year rose over the same years.

The health advisory board, comprised of over 30 providers and experts, also noted that virtual psychotherapy visits had been one of the categories of care that experienced an unusual increase during the pandemic.

“Before the pandemic, the vast majority of visits took place in person,” said David Auerbach, the commission’s senior research director. “After the pandemic, more than 85% of visits were delivered via telehealth.”

This increase occurred among all age groups, but it was mainly driven by young adults, who had the highest number of visits and the most significant growth throughout 2020.

Auerbach said this statewide upward trend for psychotherapy visits represents the prevalence of mental health conditions in the state population in recent years.

Within the past year, about 1,155,000 Massachusetts residents reported a mental health condition, demanding a need for more care.

Brockton-area providers cope with influx of patients

This trend reflects what some Brockton-area healthcare providers have experienced in the past couple of years.

“There’s definitely more patients presenting with depression and anxiety,” said Christine Rowan, the director of social work at Signature Healthcare Brockton Hospital. “We have a population with persistent mental illness.”

Rowan noted that since some mental health treatment options were limited during the COVID-19 outbreak, many turned to their local emergency departments.

“If [patients] were going to day programs and those closed, it certainly impacts their ability to cope, and then they experience an acute exacerbation of their chronic mental health illness,” she said. “The emergency room has experienced such a strain with the volume [of patients].”

Rowan said that hospitals treating an increase in emergency department boarding for mental health issues is challenging, especially with some patients waiting for extended times.

For many, the waiting period to receive care from local partnering agencies can be as long as four months, according to Rowan.

“There’s a miss in terms of connecting the patient [with outpatient care],” Rowan said. “Subsequently, without treatment, results in a return to the emergency room with an elevation of their symptoms.”

The HPC reported that this increase in inpatient emergency department visits for mental health cases is a statewide issue, up 8% over 2019, the highest growth in the trend.

“The growth in [emergency department] boarding is all coming from mental health emergency visits,” Auerbach said. “Almost half [of patients] end up in the emergency department for at least 12 hours.”

Some providers are also concerned that the increased need for mental health care services will strain hospital spending and costs.

“I’ve had as many as 17 patients in an [emergency department] that has 33 beds, and it’s not the right place,” said Christine Schuster, the president and CEO of Emerson Hospital in Concord. “Everyone is working on this, but it does add to our costs.”

Schuster noted that these extra costs are unavoidable.

“We have sitter costs that are involved to keep these patients safe, as well as additional psychiatric staff to come in to help,” she said.

New facility comes online in Brockton

This new finding follows the official opening this month of a new 24/7, 82-bed inpatient mental health facility in Brockton.

Located on North Pearl Street, the Brockton Behavioral Health Center will have various options for patients needing inpatient psychiatric care, like, group counseling, education about substance use disorders and self-help programs.

According to Boston Medical Center representatives, the center will work with emergency rooms and providers from Boston down to Brockton to help create more space and alleviate the demand for all mental health services.

Rowan, who receives between 450 to 500 referrals to social work for psychotherapy per month, hoped so.

She pointed to a need for more capacity in all areas of the behavioral health system in the state, including outpatient resources, acute care and long-term treatment beds and services.

“There’s a high demand, so any addition of beds and treatment is going to be a help,” she said.

“Whether or not it’s going to sustain will remain to be seen.”

This story originally appeared in The Enterprise.

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