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June 5, 2014

Psych services begins change

By Denise Richardson The Daily Star
Cooperstown Crier

---- — A key switch in mental health services in the four-county area took effect last weekend.

The Mobile Crisis Assessment Team staff started handling crisis calls Sunday, officials said, and the Bassett Medical Center crisis center, which is an extension of its emergency department, is set to close.

Bassett’s 10-bed inpatient psychiatric unit in Cooperstown remains open pending review by the state Office of Mental Health of an application for its closure, officials said.

Meanwhile, the transition is gearing up for the MCAT program to provide mental health services that providers said they hope will reduce hospitalizations and offer more community-based care.

A primary step is publicizing that Bassett’s Psychiatric Crisis Center hot-line number, (877) 369-6699, will remain in service but be answered by MCAT staff, officials said. Or callers may dial (844) 732-6228 to reach MCAT directly.

MCAT staff will be available 24 hours a day, seven days a week. Services include mental health assessment, de-escalation and debriefing of crisis situations, referrals and follow-up services.

In the local MCAT model, three team members will be in Otsego County and one each will be in Delaware, Chenango and Schoharie counties. The state Office of Mental Health will provide $1.2 million annually to the counties for the program, which won’t draw on local dollars, officials said.

The Oneonta Police Department last year reported a trend of more calls involving mental health issues, including some cases resulting in transporting patients to a hospital for psychiatric treatment. Police have expressed concern about increased demands on the department if and when the Bassett inpatient psychiatric unit closes because patients will have to be taken to facilities outside the area.

With initiation of the MCAT coverage, some logistics remain to be worked out, which may not be realized until the program is implemented, city police Lt. Douglas Brenner said Wednesday.

Brenner said in situations when someone is threatening to injure themselves or others, callers should dial the 911 emergency number.

MCAT has hired two of six employees for the local program, said Susan Matt, director of community services for Otsego County, and interviews and background checks continue. Hotline calls will be answered by staff at the Neighborhood Center in Utica, which manages the MCAT program, she said.

Last year, Bassett reduced its inpatient psychiatric unit from 20 to 10 beds. In April, faced with staffing issues, including a national shortage of psychiatrists, it announced closure plans.

The Office of Mental Health received Bassett’s application April 7, Benjamin Rosen, director of public information for the state office said.

Under OMH regulations, Bassett’s request is subject to a 20-business-day review, according to Rosen. The process allows for clarification of key issues, for more information to be requested and for a coordinated planning process regarding the application, among other steps.

After findings and recommendations are received from the reviewing parties, an application also must be studied by the state Behavioral Health Services Advisory Council and approved by the Commissioner of the Office of Mental Health.

“We have been answering their questions and providing detailed information regarding the provision of mental health care in the region if the closure plan were to be accepted,” Karen Huxtable, medical center spokeswoman, said in an email Tuesday.

Bassett’s Psychiatric Crisis Center was a place for individuals experiencing a mental health emergency, Huxtable said, and staff in the center not only provided an assessment of the individual but also linkages to community resources, such as outpatient care and referrals to social services for help, such as with housing.

The MCAT program will provide those services, she said.

“While our crisis center is closing, the emergency department staff can still accept mental health emergencies and assess whether the individual needs hospitalization or can be discharged with follow-up outpatient care,” Huxtable said. A patient needing to be hospitalized could be admitted to Bassett if a bed were available, she said.

Huxtable said the MCAT initiative predates Bassett’s proposal to close the inpatient psychiatry unit. MCAT already runs a successful program in Herkimer and Oneida counties, she said, and in 2012, MCAT’s services kept 92 percent of adult clients and 94 percent of children out of the hospitals.

Matt said she and other mental health professionals recently have been meeting or communicating with law enforcement, ambulance companies, county departments and A.O. Fox Memorial Hospital, Oneonta, and Bassett staff to prepare for the June 1 change to the MCAT program.

MCAT also is designed to provide more outreach to patients and their relatives, Matt said.

Bassett has applied to other programs pertaining to providing mental health services, including the Vital Access Provider, to expand community-based outpatient psychiatry services.