Asking the right questions about mental health services in the Finger Lakes

Reaction was swift throughout the region when Finger Lakes Health officials said recently that they were seeking permission from New York state to shutter a behavioral health program in Yates County.

Of the unit in Penn Yan, Brittney Christensen, a registered nurse speaking on behalf of a community organization opposed to the proposed closure, said it sent the wrong message to the community. Especially to those in need of mental health services. “Apparently, the unit is being closed due to ‘low volumes and reimbursement,’” she said in a letter, which appears on this page. “Essentially, reporting to our community that our mental health is not financially beneficial to those making these decisions.”

Her point: That mental health services are essential if we want to de-stigmatize mental illness. Furthermore, the services are necessary if we want those who suffer from mental illness to be contributing members of society. “[It] ultimately portrays the detested stigma that if you suffer from mental illness you are less likely to be a contributing member of our society,” she said.

Christensen raises valid points especially in regards to predicting mental health treatment, insurance coverage or the total cost of necessary services to address mental illnesses.

Lara Turbide, spokesperson for Finger Lakes Health, said in an email that, “As with any service changes, significant consideration is given to community need, volumes, and financial viability.” She added that there would be “no closure of the unit until the OMH and DOH provide such approval.” She went on to note that FLH has merely started the process, requesting to discontinue services. Turbide also noted that Finger Lakes Health is engaged directly with regulatory agencies for the appropriate steps related to the request of closure.

She said that volumes were regularly in the single digits, with some days having no patients at all. Turbide also noted that approximately 40 percent of patients served were from other counties. Another point Turbide makes is that there are several other inpatient psychiatric units operated by other area health systems also operating below capacity in the region who can and are willing to accept referrals.

“If we do close the inpatient psychiatric unit at Soldiers & Sailors, we, Finger Lakes Health, will continue to make referrals as clinically appropriate to other area facilities and will continue to offer out-patient care at the John D. Kelly Center in Penn Yan,” Turbide said.

When the discussion centers around “low volumes” or utilization rates, a lot of assumptions are made for entire communities. And unfortunately, when the debate is started, we all too often fall into the habit of asking: Why are we doing this? Instead of asking the more-important question: Why is this service or this thing underutilized?

If “community need, volumes, and financial viability” are the “factors” at play when a decision like this is being made, how do they rank? Do they all represent an equal 33 percent share? Or does one outweigh another?

The assertion that community need dictates fewer available services, instead of more, is a statement based not in fact or reality. If a company or business, wants to assess community need by simply counting the number of folks who pass through their doors, that’s fine. But let’s not confuse that for actual community need. That’s not a scientific analysis of any given community. Especially rural ones, that often are lost in the shuffle of verified data collection as it is.

Last summer the Centers for Disease Control released a damning report, which showed a 28.8 percent increase in suicide between 1999 and 2016 across New York. Even more concerning: The fact that the CDC found that more than half (54 percent) of people who died by suicide weren’t diagnosed with a known mental health condition.

Again, as communities in the Finger Lakes, we need to ask ourselves why programs or services like these are underutilized, not why we operate them if they see low turnout or utilization.

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