Health

Mercy Iowa City to close inpatient mental health unit

Hospital officials cited financial challenges from ongoing pandemic, plans to expand outpatient services

A temporary COVID-19 testing facility outside the emergency entrance is seen at Mercy Iowa City in March. (Andy Abeyta/T
A temporary COVID-19 testing facility outside the emergency entrance is seen at Mercy Iowa City in March. (Andy Abeyta/The Gazette)

IOWA CITY — Mercy Iowa City plans to close the hospital’s mental and behavioral health unit in November due to the financial challenges presented by the ongoing COVID-19 pandemic.

Hospital officials confirmed to The Gazette this week the inpatient behavioral health unit will close by the end of the year “in favor of expanding our outpatient service where there is greater community need.”

“Behavioral health services play an increasingly important role in our community,” Mercy Iowa City spokesman Aaron Scheinblum wrote in a statement. “ Mercy’s Behavioral Health Clinic will continue to see and support our behavioral health patients within the community.”

The last patient in the unlocked inpatient psychiatric health unit will be accepted Nov. 1, according to the statement.

Mercy Iowa City officials declined to respond to multiple follow-up questions from The Gazette, including how officials planned to expand outpatient services.

They also did not specify whether staff were laid off as a part of the decision.

Mercy Iowa City, an affiliate of the MercyOne network, employs eight psychiatrists and psychiatric advanced care practitioners within the unit, according to its website.

A number of the same providers also work in the Mercy Behavioral Health Clinic, at 1067 Ryan Court in Iowa City. Mercy Iowa City also has a clinic in Muscatine.

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Mercy Iowa City officials did not clarify where patients in need of inpatient behavioral health assistance would receive that care.

Other mental and behavioral health providers likely will feel the impact of this closure, said Erin Foster, director of the mental health access center set to open in Linn County this year.

“We know when other options for behavioral health are taken away, it potentially raises the need for more crisis services,” Foster said.

The announcement comes at a time when the University of Iowa Hospitals and Clinics, a larger health care center in Iowa City, says its facilities are overwhelmed with patients — including those in need of behavioral and mental health services.

CEO Suresh Gunasekaran told Iowa’s Board of Regents earlier this week the average daily patient count numbers almost have reached capacity and inpatient transfers from other health care facilities across the state have returned to pre-COVID-19 levels.

However, many of these patients are even sicker than pre-pandemic times.

“We’re trying to figure out how to manage the increasing volume of behavioral health patients that are in distress and need care,” Gunasekaran said Wednesday.

“In August, the main reason the left-without-being-seen (number of patients) was so high was the large number of behavioral health patients that were in the (emergency department) that we couldn’t move because the beds upstairs were completely full.”

Up to mental health regions to fill the gap?

With the ongoing pandemic, the repercussions of the derecho and other significant events in recent months, local officials say this year has taken a toll on the mental health of residents.

“With COVID-19, the derecho, national politics and 2020 in general, we know that need for mental health services has increased significantly,” Linn County Supervisor Ben Rogers said.

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Some of these patients may be taken in by the mental health regions, which was expanded by state officials in an effort to direct this care for adults and children from state institutions to community-based service providers.

The East Central Region serves nine counties in Eastern Iowa, including Johnson and Linn counties.

“The East Central Region is a funder of last resort, so if a gap in services is created by the closure of inpatient services, the East Central Region could play a significant role in helping to fill in that gap,” said Rogers, who also is a region board member

The goal of the regions always has been to increase the accessibility of mental health services and substance use disorder treatment for those in need, Foster said.

Among its initiatives in recent years, region officials established the Linn County Access Center, a facility meant to provide short-term assistance for individuals in crisis that is directed by Foster.

The center is meant to redirect patients who normally would end up in an emergency room or in jail.

“We hope to have created a model that will allow us to help a large number of patients who may not have either sought help at all or need assistance much sooner than what another available provider could handle,” Foster said.

Financial challenges not unheard of

Mental health and substance use disorder programs have always been underfunded, Foster said.

“Many providers are fee-for-service based and even, in perfect conditions, those services are not reimbursed at a rate that comes close to equaling the amount of time a provider puts into working with a patient.”

Throw in the economic hardship that comes along with a pandemic and a natural disaster such as the derecho, which tore through parts of Iowa in early August, providers are feeling that financial burden more than ever.

That’s particularly true when some of those same stressors brought this year also significantly has increased the need for services among local residents.

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Foster said many of these providers have adjusted to new norms and found ways to still meet patient needs through avenues such as telehealth. They’ve also found stability through federal funding to help pay for staff time and personal protective gear, among other expenses.

However, Foster said many local providers are fearful the funding will end “before the impact of a situation like COVID-19 has balanced out.”

The Gazette reporter Vanessa Miller contributed to this article.

Comments: (319) 398-8469; michaela.ramm@thegazette.com

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