PeaceHealth Oregon West Network – Crisis Mental Health Services

Overview

PeaceHealth is a family of hospitals, clinics, doctors, and laboratories based in the Pacific Northwest. Its network of faith-based, mission-oriented facilities has grown to include services throughout Oregon, Washington and Alaska. PeaceHealth Oregon West Network is one of four networks offering a broad spectrum of medical care. This network has four medical centers in Eugene, Springfield and critical access hospitals in Cottage Grove, and Florence. In addition, there are 12 primary and specialty care clinics. Oregon West Network has become a leader of health care delivery services in Oregon, especially in the delivery of behavioral health services for those residents who are most vulnerable.

PeaceHealth Behavioral Health Services (BHS) is composed of a continuum of care that provides a range of services, including inpatient psychiatric care, partial hospitalization, transition services, telemental health, crisis services, outpatient psychiatry and counseling, research projects, primary care integration, young adult and first-episode psychosis-specific treatments.

Since 2003, PeaceHealth BHS has been providing crisis mental health services, regardless of ability to pay, in its emergency departments (EDs). Patients who come to the ED experiencing a mental health crisis are cared for by a team of mental health evaluators, available 24 hours a day, 365 days per year. Team clinicians are skilled in in the diagnosis and treatment of mental disorders and crisis intervention counseling. They determine the need for psychiatric hospitalization or prepare follow-up plans for patients’ safety.

In 2009, PeaceHealth BHS began a Telepsychiatry Health Crisis service, to provide mental health evaluations to the health system’s rural hospital in Florence, Ore. The Florence hospital had lost most of its indigent care funding and did not have crisis coverage during evenings and weekends. Since that time, PeaceHealth BHS has expanded the Telepsychiatry Health Crisis program to cover its other urban hospital, Sacred Heart Medical Center at RiverBend to allow for 24-hour coverage.

Impact

Each month, the team provides mental health evaluations for more than 350 patients in emotional crisis. As a result of PeaceHealth’s ability to staff its EDs with mental health evaluators, PeaceHealth BHS patients are rapidly assessed for dangerousness to self or others and are offered “just in time” mental health counseling. In addition, assistance is offered to the families and loved ones of those in crisis.

The ability to provide telepsychiatry health crisis evaluations to the health system’s rural hospital has assisted physicians with the expertise to determine the mental health needs of patients. It has allowed timely assessment of patients in mental health crisis and provided consultation on safe dispositions, reducing the experience of prolonged wait times in the ED setting. Each month, BHS provides telepsychiatry health evaluations to approximately 12 crisis patients in its rural and urban hospital settings.

Lessons Learned

Adequate staffing has always been a challenge, especially during times of surge. In addition, the need for core staffing of regularly scheduled staff has been difficult. Due to the charitable nature of the service, funds are managed prudently. The stressful nature of the position also requires an ability to find rejuvenation and refreshment in ongoing training. This is something PeaceHealth BHS has not had the funds to provide, except on a very limited basis.

Future Goals

Program leaders plan to increase the core staffing of regularly scheduled clinicians, offer funds for ongoing clinical training in psychiatric emergencies, and expand the telepsychiatry service to other rural hospitals.

Contact: Mary Anne McMurren
Vice President, Post-Acute Services
Telephone: 541-338-1656
Email: mmcmurren@peacehealth.org