While one out of four Rhode Islanders struggle with a mental illness, past data has shown that an average of only 50 percent seek care. The unprecedented number of patients seeking mental health care at Butler Hospital this summer may indicate more people are now reaching out for help. This time last summer, Butler Hospital's daily inpatient census hovered at around 153. This summer the daily census averaged 175 with peak days reaching over 190. Increased numbers of patients seeking mental health care were not just being seen at Butler, a psychiatric hospital, but also in the emergency departments of general hospitals across the state.
The exact cause of this unprecedented high summer census is unknown; however, greater awareness of psychiatric illness, along with an increase in the number of people who have insurance due to the Affordable Care Act may be factors. "With the advent of the insurance exchange, more people are seeking the care they need. Our data indicate that many of the patients we are seeing have not been hospitalized in the past, and the number of uninsured patients we care for has decreased," stated Lawrence H. Price, MD, acting president and COO, Butler Hospital. Dr. Price also noted that for some patients, while mental illness was the primary reason for seeking care, the admission to Butler resulted in the opportunity to identify other physical health care needs that have also been overlooked due to lack of insurance.
According to an article published by The New York Times on August 28, "The Affordable Care Act has paved the way for a vast expansion of mental health coverage in America, providing access for millions of people who were previously uninsured or whose policies did not include such coverage before. Under the law, mental health treatment is an "essential" benefit that must be covered by Medicaid and every private plan sold through the new online insurance marketplaces." The Times also refers to the challenge of meeting the demand greater access creates.
In an effort to address the overwhelming need for inpatient psychiatric care in the Rhode Island community, Butler Hospital opened an Adult Inpatient Overflow unit on the weekends. Fully staffed, including physicians, nurses, activity therapists, social service clinicians and mental health workers, the unit enables Butler patients, who would otherwise have to wait in emergency departments for an available bed, to begin their care more quickly in an environment that is supportive of their needs.
While this summer's patient volume is a record high, it is part of a trend Butler began to see in February when the hospital struggled to meet community demand despite having recently opened a new 26-bed inpatient unit. The hospital informed the Department of Health of the record census and will continue to staff the overflow unit as needed. "We will monitor the community need for inpatient care and work with the state and other providers in planning for any long term solutions needed," stressed Dr. Price.