Mount Sinai Beth Israel’s impending closure is raising concerns about how nearby Bellevue Hospital Center will be able to handle the expected influx of psychiatric emergencies.
Bellevue, a safety net hospital in Kips Bay, will be the only emergency department in the area capable of taking psychiatric cases when Beth Israel, a roughly 500-bed hospital a few blocks away, closes its doors, said Health + Hospitals CEO Mitchell Katz in testimony at a City Council hearing on the public hospital system’s $2.3 billion preliminary budget proposal on Thursday. Much of a $28 million fund Mount Sinai agreed to pay to shore up Bellevue’s services will go toward expanding a psychiatric emergency unit to meet the increased demand in what is already the busiest mental health ER in the city, he said.
Bellevue receives more than 8,000 adult psychiatric emergencies each year, serving a large number of homeless individuals and people with substance use issues. It’s the biggest recipient of people with severe mental illness who police have involuntarily taken to a hospital. When Beth Israel closes its doors – a process that has been working its way through the courts against local opposition – many of its patients will go to Bellevue.
The hospital is preparing for the increasing number of patients. Part of the $28 million will go to the purchase of a new CT scanner, which is the most needed item in relieving bottlenecks because it helps determine whether a patient needs to be admitted or discharged, Katz said. The machine itself will cost $1.5 million, and renovating the space will require another roughly $4 million. Another $2.5 million will go toward respite beds for people who are ready to be discharged but have no place to go, Katz said, a common occurrence that drains hospital resources.
But what most worries Katz is the physical and staffing needs required to expand Bellevue’s comprehensive psychiatric emergency program because of the dearth of other options in Lower Manhattan, he told the Council’s Committee on Hospitals.
Mount Sinai Behavioral Health Center on Rivington St., one of the other nearby facilities expected to take many of the former Beth Israel patients, does not have an emergency program despite having a psychiatric ward. Part of the difficulty is a state regulation that requires facilities to also have a medical emergency department if they want to have a psychiatric one, Katz explained. As a result, patients will most likely have to go through Bellevue’s emergency department before they can be admitted to the Rivington site or elsewhere.
Loren Riegelhaupt, an independent spokesman for Mount Sinai, said the Rivington location would continue to accept patient transfers from Bellevue to its 115-bed facility. He said the site would also offer outpatient services that do not require admission, which would assist Bellevue with follow-up.
But regardless of the transfer agreements, the new flow of mental health patients would all have to begin at Bellevue.
“All of them will have had to go through our medical emergency department at Bellevue first. So I’d say that’s the group that I particularly worry about,” Katz said.
