MANKATO — A fifth of all stays in psychiatric units at Minnesota hospitals are avoidable, according to a new report.
The Wilder Foundation partnered with the Minnesota Hospital Association to track stays at 20 participating hospitals — including Mayo Clinic Health System in Mankato — throughout the state during a 45-day period in spring 2016.
What they found is that 19 percent of the 32,520 mental health hospital stays tallied in the study would be better served in another setting.
Ideally the patient could receive less intensive care that doesn’t require an extended stay at a hospital, or more intensive care in a state psychiatric hospital.
The problem is resources and beds aren’t available elsewhere to handle the great need. A lack of beds at state-operated facilities was the most frequently cited reason for the avoidable stays.
Dr. Bruce Sutor, clinical practice chair for psychiatry and psychology at Mayo Clinic, said the lack of resources causes a ripple effect through hospitals such as Mayo. Once the hospital’s psychiatric beds fill up, patient numbers overflow into the emergency department. In turn, new patients coming into the emergency departments could face longer waits to receive care. Even worse, if there's absolutely no room for someone with mental heath needs at one hospital, the patient could be moved to another facility hours away where there is room.
“I can tell you right now we have 18 people waiting in the emergency department in Rochester awaiting treatment in a psychiatric bed,” Sutor said.
That situation isn’t unique to Rochester, he said.
“Absolutely it happens in Mankato,” he said. “It happens in Austin. It happens and can happen in any hospital that has an emergency room.”
Even more concerning, the 19 percent figure is likely an underrepresentation of the problem, he said. The study only included 20 hospitals during a relatively small window of time.
Dr. Rahul Koranne, Minnesota Hospital Association’s chief medical officer, said the strain on the health system is felt across the board when a patient is stuck in bed at a hospital. Patients and families don’t receive the care they need, while nurses and physicians are tasked with even more difficult work.
“Nobody wins when a patient is sitting in a hospital bed and it’s not the right place for that patient,” he said.
Having the data, even if it is just a snapshot from a 45-day window, at least helps start the conversation on how to fix the mental health system in Minnesota, he said.
“We will need to work on this together,” he said. Now that we have the data, we can have communication with the state to see how we can have these community resources so we don’t strain the entire system.”
Sutor is part of the governor’s task force on mental health. The group has just started looking at possible solutions, and the issue goes far beyond simply adding more beds at state facilities — although that’s needed, too.
Sutor said an organized, readily accessible mental health care delivery system is what’s needed in the state. Such a system could include more access to psychiatrists, more funding for crisis teams that come to the patients in need, and other services aimed at preventing the avoidable hospital stays.
Koranne said the hospital association will be working with the state department of human services and legislators to help fix the problems identified in the study.
“We are very hopeful that the state will look at this data,” he said. “And we can continue to advance the conversation for what we can do to help all people in Minnesota.”