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Providence to close children's inpatient psychiatric center at Sacred Heart

Spokesman-Review - 7/10/2024

Jul. 9—Sacred Heart Medical Center will close its children's psychiatric unit on Sept. 7, Providence announced Tuesday.

Chief Medical Officer Dr. Dan Getz said financial losses and difficulty finding enough child psychiatrists led to the decision.

The Psychiatric Center for Children and Adolescents cares for children ages 12 to 17 with depression, anxiety, bipolar disorder, acute psychosis or other diagnoses that require inpatient hospitalization. The unit is licensed for 24 beds, but capacity has been reduced to eight on the heels of provider shortages.

Getz said the unit needs at least four more psychiatrists amid a national shortage — especially for those specializing in inpatient pediatric treatment — that increased during the COVID-19 pandemic. If the unit was fully staffed, it would not be closing, he said.

The decision came through a formal process involving experts and ethics leaders who considered the nonprofit's mission to care for the poor and vulnerable.

The adult inpatient psychiatric unit will not be affected.

The closure will cut about 50 positions. The majority who work in the unit are registered nurses and mental health counselors. Human resources will identify other employment within Providence where possible, communications director Beth Hegde said.

Over the next two months, the psychiatric team also will identify a care plan for each patient, and they will be referred to other programs in the community.

"We are not stepping away from caring for children with psychiatric needs," Getz said.

Seeing the growing need a few years ago, Providence partnered in a joint venture with Universal Health Services to open Inland Northwest Behavioral Health, which includes 25 beds for teens on West Fifth Avenue and Browne Street.

"If we didn't have INBH, I don't think we could have made this decision," Getz said.

Jamie Valdez, director of business development for INBH, said the facility is fully staffed and usually operates close to capacity, but it should be able to accommodate the influx in patients.

Between both programs, about six to eight new patients are admitted every week, Hegde said. Sacred Heart had six patients in its pediatric inpatient psychiatric unit over the weekend.

Across the state line in Coeur d'Alene, Kootenai Health treats children ages 10 to 17 at its inpatient Youth Acute Unit.

Although it is licensed for 34 beds, the facility can accommodate up to 20 patients, based on the current number of providers, youth service program manager Brandee Lawhead said. There is not a staff shortage, however, because the unit usually has 14 to 16 patients a day.

If capacity were to increase, most rooms would have to double up, which can be hard for treating youth, Lawhead said.

The unit typically treats patients from North Idaho, Eastern Washington and Western Montana, but in the last three years, referrals have widened to Western Washington, Oregon and Eastern Montana.

While Kootenai Health has been fortunate with staffing, Lawhead said there is still a huge need for providers in the community, including outpatient psychiatrists.

Beyond general mental health treatment, there is also a shortage of beds in the region treating youth with drug addiction.

Providence will continue to invest in its two outpatient programs, Getz said.

RISE, which stands for Resources, Insights, Support and Empowerment, is an intensive daytime and after school mental health treatment program for adolescents. BEST, which stands for Behavior and Educational Skills Training, is a day treatment program for children 7 to 12 years old.

Although it is not a solution for every situation, there are advantages to outpatient care where a child can go home to a familiar setting every night and work on the skills they learn with their family.

Children in psychiatric crisis can still be admitted to the emergency room, Getz said, and the hospital will identify other facilities for patients needing ongoing inpatient care.

The children's psychiatric unit is losing about $2 million a year as reimbursement rates are not keeping up with rising care costs. The unit also needs significant facility upgrades.

Sacred Heart, like other hospitals, has faced much wider financial challenges since the pandemic from staff shortages, supply chain inflation and other costs. The hospital had $175.5 million in operating losses in 2023, according to Department of Health data.

"We had to make a challenging decision," Getz said. "The question is, how do we continue to sustain the mission that Providence serves in this community?"

As the area's only Level II trauma center, Spokane's largest hospital had to prioritize other critical medical care. The way forward will be to continue to find ways to be more efficient across all departments, Getz said.

While more can be done to encourage medical students to study pediatric psychiatry, Getz said it is a job that takes a special kind of person who feels called to it.

In addition to a residency program, Providence developed a fellowship for additional training, but that position has gone unfilled.

Because of the community need for specialized caregivers, Getz said those employees who are not able to find new positions in the Providence system will likely find other jobs in short order.

"These people are highly skilled," Getz said. "We would be shocked if they didn't have offers elsewhere."

James Hanlon's reporting for The Spokesman-Review is funded in part by Report for America and by members of the Spokane community. This story can be republished by other organizations for free under a Creative Commons license. For more information on this, please contact our newspaper's managing editor.

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