Nurses and mental health advocates are pleading with New York–Presbyterian Brooklyn Methodist Hospital to reverse its plan to cut its inpatient psychiatric care capacity by at least half.
Members of the New York State Nurses Association protested the planned changes outside the hospital Tuesday. They question the timing of the plan as advocates fear worse outcomes for patients with serious mental illnesses and substance-use disorders because of the social isolation and economic upheaval caused by COVID-19.
Nurses were told May 28 that Brooklyn Methodist plans to close 25 of its psychiatric beds indefinitely, with the other half unavailable for the next 12 to 18 months, said Irving Campbell, a psychiatric nurse practitioner and NYSNA member at the hospital.
One of the units is currently serving as an intensive care unit and the other as a medical/surgical unit in which nurses who normally care for psychiatric patients are treating patients suspected of having COVID-19. Psychiatric patients needing inpatient care are currently being treated at other New York–Presbyterian facilities, Campbell said.
"With the pandemic, we're seeing a greater need for psychiatric services as well. Anxiety, depressive disorders, substance-use disorder, child abuse, domestic violence—all of these markers are increased," Campbell said. "People are losing their jobs. They're feeling hopeless and helpless, and all of the experts have pointed to the crisis right now in mental health. So the loss of 50 beds, especially in Brooklyn of all boroughs, is a huge loss, if the plan goes through."
A New York–Presbyterian spokeswoman declined to answer questions about the hospital's plan for psychiatric care. She said flexibility would help the hospital handle a resurgence of COVID-19.
"The COVID-19 pandemic has shown that hospital bed flexibility, particularly in expanding vital ICU bed capacity, is essential in order to provide the best possible care to every patient," the spokeswoman said. "While we currently are maintaining our readiness for a potential future surge here in New York, our commitment to exceptional behavioral health care is unwavering."
The move follows a decision by New York–Presbyterian two years ago to close the psychiatric unit at Allen Hospital in the Inwood section of Manhattan, which faced similar opposition from nurses and community health activists. Allen Hospital needed the space to build out maternity care and its spinal surgery specialty, which opponents noted is a more lucrative service line than mental health.
New York–Presbyterian at the time said the shift toward more outpatient mental health services would help meet demand. It has inpatient psychiatric beds at Gracie Square Hospital in Manhattan and the Westchester Behavioral Health Center in White Plains.
Campbell said he thinks patients who come to Brooklyn Methodist's emergency room for psychiatric or substance-use treatment will be more likely to refuse to be admitted if they know they will be transported out of Brooklyn.
Matthew Shapiro, associate director of the state chapter of the National Alliance on Mental Illness, said in a statement that he "is deeply disturbed that at a time when mental health services are going to be needed at unprecedented levels, we continue to see crucial inpatient services being reduced."
NYSNA, the state's largest union of registered nurses with about 42,000 members, said it has seen large health systems reduce behavioral health services around the region.
The union noted that NYC Health + Hospitals has cared for a growing number of psychiatric patients while private hospitals' inpatient psych units have shrunk.
Campbell, the nurse at Brooklyn Methodist, said the closure could strain capacity at other Brooklyn facilities, such as the city's Woodhull and Kings County hospitals and private Maimonides Medical Center.
"Other facilities in Brooklyn are also feeling the stress because of our 50 beds not being in use," he said.
"Nurses fight to protect psychiatric care at Brooklyn hospital" originally appeared in Crain's New York Business.