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Mental Health Care Emergency Looms, N.Va. Officials Warn

By Eric M. Weiss
Washington Post Staff Writer
Wednesday, November 17, 2004; Page B01

Four psychiatric wards in Northern Virginia have closed recently or will be shut down soon, eliminating 100 beds and threatening to create a mental health care crisis, health officials say.

The closures at four suburban hospitals are the result of national trends in health care economics, but the fallout could mean longer waits in emergency rooms, more mentally ill patients in jails and fewer options for very troubled -- and occasionally dangerous -- people, mental health advocates say.


The closure of the psychiatric unit at Potomac Hospital, above, and at three other hospitals puts more pressure on the sole state-run hospital. (Margaret Thomas -- The Washington Post)

"You have to practically die before you're able to get any help," said Dotti McKee, whose schizophrenic son has been shuttled from hospitals to homeless shelters to jail cells in Fairfax.

The recent closure of the psychiatric units at Potomac Hospital in Woodbridge and Inova Alexandria Hospital and the planned closure of Dominion Hospital in Falls Church and Northern Virginia Community Hospital in Arlington will place more pressure on the sole state-run hospital in the area, which is already over capacity.

"A drastic situation is going to get a lot worse," said George Barker, associate director of the Health Systems Agency of Northern Virginia, a regional health planning agency. "It raises major concerns about how all these people will be accommodated."

The disappearance of psychiatric beds in Northern Virginia grows out of an ad hoc national mental health system in which resources and economic incentives do not match needs, advocates and planners say. There is desperate demand for short-term options for mentally ill people in their own communities -- acute-care hospital beds, halfway houses, outpatient support services and detoxification programs.

But public and private insurance reimbursement rates, which cover a fraction of the cost of care, make mental health a financial loser. Also, more than one-fourth of mentally ill patients have no insurance, health officials say, meaning hospitals often swallow the cost of care.

Potomac Hospital closed its 12-bed psychiatric unit three weeks ago after losing what it said was $4.7 million on mental health services since 1998.

"Basically, it was a cost issue,'' hospital spokesman Leigh Dunlap said.

A growing national nurse shortage means that even when there is an empty bed at a private or community hospital, a patient may be turned away because appropriate staff members are unavailable to provide care to a difficult or violent patient.


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