Rush University Medical Center will no longer offer inpatient mental health care for children, making it the latest Chicago hospital to cut back on overnight stays for kids.
The West Side hospital had 15 beds for child and adolescent behavioral health. It temporarily closed that unit in March, along with two adult inpatient mental health units, after the state found deficiencies in how the hospital protected its psychiatric patients from harming themselves through hanging or strangulation. The units were supposed to reopen following renovations to correct the issues and the state’s approval, but Rush has decided the pediatric unit will not reopen.
Rush is closing the unit partly because of a lack of demand, said Dr. Robert Shulman, associate chairman for the department of psychiatry and director of clinical services. Only about half the beds in the unit have been full on a typical day, he said.
Instead, Rush plans to create intensive outpatient mental health programs for children and adolescents, he said.
“It allows us to put the resources into the outpatient programming,” Shulman said. “We can treat more individuals this way and hopefully prevent the high-cost, short-term acute hospitalizations.”
Children who arrive at Rush’s emergency department in need of inpatient psychiatric care will be referred elsewhere, he said. Shulman said there are enough other facilities in the area providing those services that finding beds for those patients shouldn’t be a problem.
The elimination of the Rush unit is “not going to cause a gap in care in the community,” he said.
About 30 staff members worked in the unit, and are all being offered other jobs within Rush or exit packages, he said.
Rush leaders called it a “difficult decision” in an internal memo distributed Tuesday, noting that “there is great demand in the adult population” for inpatient behavioral health services. Rush is partnering with West Side community groups to improve behavioral health in the area, including by training lay people in interventions for depression, trauma and substance abuse.
The elimination of the unit at Rush follows a trend of many Chicago-area hospitals reducing their inpatient beds for kids, as more care is done on an outpatient basis and children’s hospitals tend to attract patients with complex needs.
Illinois hospitals had more than 1,100 beds dedicated to adolescent acute mental illness as of 2017, according to the state Department of Public Health.
Some providers have reported shortages of psychiatric beds for children in parts of the Chicago area.
Recently, MIRA Neuro Behavioral Health Care submitted an application to the state’s Health Facilities and Services Review Board to build a 30-bed behavioral health hospital in Tinley Park for children with acute mental illness. As part of its application, it included letters from more than 40 area high school superintendents, principals, counselors and social workers, among others, supporting the project.
The school officials and the Illinois Association of School Nurses signed nearly identical letters of support saying: “We have personally experienced difficulty accessing pediatric and adolescent psychiatric support for the many children and families we serve, especially during an acute crisis. The local hospitals do not have the appropriate clinical resources to service children and adolescents who require inpatient hospitalization.”
Also supporting the project was Palos Health’s Medical Director of Emergency Services George Borrelli, who wrote in a letter to the state’s review board that Palos Health’s emergency department has “faced an ongoing challenge in finding appropriate psychiatric inpatient care for adolescents and children” leading to “inordinately long stays in our Emergency Department awaiting placement.”
That project is scheduled to be considered by the state board in August.
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Child psychiatrists are generally in short supply in Illinois and across the nation, which can lead to long waits for children who need help as outpatients. A number of area hospitals are working to address that issue.
Lurie Children’s Hospital plans to use a $15 million donation from the Pritzker Foundation to help it expand a program to train specialists and pediatricians to better treat mental illness, supporting them as they work with children.
And Advocate Aurora Health recently applied to the state Health Facilities and Services Review Board to relocate its outpatient behavioral health services and pediatric development program to a new $40 million facility near Advocate Illinois Masonic Medical Center.
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