Health Care

Pine Rest aims to ease strain on ERs

Organization’s Psychiatric Urgent Care Center treats behavioral health issues.

April 26, 2019
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Pine Rest
The nearly $3 million center provides immediate assessment and treatment for adults experiencing acute psychiatric symptoms who cannot wait for routine outpatient intervention. Courtesy Pine Rest

Kent County’s first urgent care center for mental health is now open.

Pine Rest Christian Mental Health Services opened the Psychiatric Urgent Care Center on April 15 at its main campus in Cutlerville, at 300 68th St. SE.

The 14,000-square-foot center is inside the $12.4-million expansion completed in 2017 that included a 26-bed adolescent and young adult unit and updates to the hospital entrance and contact center.

About $3 million of that investment was used to establish the urgent care center, designed to provide immediate assessment and treatment for adults ages 18-65 experiencing acute psychiatric symptoms that cannot wait for routine outpatient intervention.

Such symptoms could include depression, anxiety, panic attacks, disturbing thoughts, suicidal thoughts, acute grief reactions, trouble managing daily activities and substance use disorders.

The goal is to keep such patients from using hospital emergency rooms unless experiencing medical emergencies.

Behavioral health issues accounted for more than 14,000 emergency room visits last year, about 85% of total visits, said Bob Nykamp, Pine Rest’s vice president and chief operating officer.

“We think that we can offload some of those really expensive care options in the emergency department and do it much more efficiently and at a lower cost,” Nykamp said.

The Metro Health – University of Michigan Health emergency room has 28 beds and has 10 to 25 people working, depending on the time of day, according to Nathan Baar, Metro Health ER director.

The Metro Health ER sees about 170 patients each day. Fluctuating depending on the season, about six to eight of those are for mental health reasons, he said.

In the past five years, he said the number of mental health ER walk-ins has doubled, and the number who have arrived by ambulance has risen by about 50%.

He said patients visiting the ER usually stay for about two hours, plus about three more if they need additional testing. In contrast, those visiting for psychiatric reasons typically stay for 10 to 12 hours.

Depending on the services needed, the cost of visiting an ER could be $700-$900, Baar said. The total psychiatric assessment at Pine Rest is less than $300, Nykamp said.

While the patients may not actually be charged for that full 10-12 hours, it takes resources away from patients who may need help with medical emergencies.

“When we could have treated three or four patients in that space, we're using that to coordinate the care for this one individual,” Baar said.

Emergency departments are not staffed with psychiatrists, and determining the proper social workers and referrals takes time.

The urgent care center is staffed with psychiatrists, as well as psychiatrically trained nurse practitioners and physician assistants.

The center has seven rooms and 15 full time-equivalent staff able to carry out about 40 evaluations per day, Nykamp said.

“If that occurred, we would have, I think, a tremendous impact on the pressure that the area emergency departments are feeling right now,” Nykamp said.

Another goal for the center is to prevent people from being admitted to a psychiatric hospital, Nykamp said.

While people who have overdosed on drugs still need to visit the ER, for example, those struggling with drug addiction could visit the psychiatric urgent care center to seek help avoiding a relapse, hopefully keeping them from needing medical services, Baar said.

More than half of referrals come from word of mouth, Nykamp said, but Pine Rest is working on a marketing campaign to help inform the general public, including employers and their employees.

Though there are ideas of who is most greatly affected by mental illness, Baar said people of all ages and backgrounds should take note of the new resource.

“There's no preferential treatment of anybody when it comes to mental illness,” Baar said. “It hits everybody equally.”

Nykamp said Pine Rest is treating the first three to six months as a pilot period, during which staff will analyze operations and determine whether the schedule and location are working, as well as whether there should be additional locations.

Scheduling decisions for the hours of operation were informed by experience and data from Spectrum Health’s urgent care centers, Nykamp said.

“I think the entire community is trying to address how to most appropriately care for this type of medical condition, and it presents unique challenges,” Baar said. “But I think as long as we keep working together on it, then we'll be heading in the right direction.”

Hours for the center are 10 a.m.-8 p.m. on weekdays and 8 a.m.-3 p.m. on weekends, closed on holidays.

Most commercial insurance, Medicare and Medicaid health plans cover the service. Some plans require pre-authorization for services, so the center recommends calling ahead.

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