Changes coming to local crisis care access
In what he called a “critical change in our crisis system of care,” SpringVale Health Centers Executive Director J.J. Boroski announced the discontinuation of their 24/7 in-person behavioral health crisis intervention services as of Dec. 31 of this year. The change will affect residents in Tuscarawas and Carroll counties.
The announcement was made at a Dec. 20 press conference called by Boroski and attended by approximately 50 people including representatives from local government, law enforcement and area schools. Boroski said the discontinuation is due to a lack of funding and a change in the way Cleveland Clinic Union Hospital handles crisis intervention in the emergency department.
Due to these changes, Boroski said SpringVale will open a Rapid Care Center at 155 Garland Drive in New Philadelphia in January to provide both urgent medical care and behavioral healthcare.
Boroski said SpringVale will continue to offer its 24/7 crisis hotline and will maintain its five-bed crisis stabilization unit on Hospital Drive in Dover.
What is potentially problematic is the new Rapid Care Center will only be open Monday through Thursday from 7:30 a.m. to 5:30 p.m. and Friday from 7:30 a.m. to 5 p.m. There will be no evening, weekend or holiday hours.
Boroski said, “(Many calls for in-person crisis intervention occur after hours) while many of us are in our bed sleeping at night, celebrating holidays and otherwise attending to matters that we normally attend to during nonbusiness hours.”
How it all came about
Starting in 2019, Boroski said SpringVale experienced a gradual decline in calls from the CCUH Emergency Department for on-call crisis workers. Historically, those professionals provided assessments that constituted the medical clearance needed for individuals to be admitted to psychiatric inpatient or detox facilities.
“Now, instead of walking into the hospital emergency department and receiving face-to-face crisis services, individuals experiencing a personal crisis are provided access to a telephone to speak with a clinician located in downtown Cleveland,” Boroski said.
The result was a decline in annual revenue for SpringVale of approximately $210,000 annually.
Boroski said while telehealth can be helpful in some circumstances, his experience is it is not effective in assessing people who are in the throes of an intense emotional crisis.
Boroski said the purpose of the press conference was not to place blame on any specific entity. At the same time, he did say the Alcohol, Drug Addiction, and Mental Health Services Board of Tuscarawas and Carroll Counties has decided to no longer provide funds for SpringVale’s 24/7 crisis intervention service.
He also said the ADAMHS Board and the Cleveland Clinic Union Hospital essentially cut SpringVale out of any discussion about the move toward telehealth assessments, giving SpringVale no advance notice of the coming changes. Instead, Boroski said SpringVale leadership learned about the changes on Dec. 2 from a staff member who happened to be providing crisis intervention services in a local emergency room.
Natalie Bollon, executive director of the ADAMHS Board, did not speak at the press conference but said CCUH only utilized SpringVale for crisis assessments for people who are indigent. “All other community members needing a crisis assessment have been assessed through Cleveland Clinic’s process for a while, but now individuals who are indigent will now go through Cleveland Clinic’s process as well.”
Bollon explained the reason funds that used to go to SpringVale for in-person after-hours assessments will be redirected to the Rapid Care operation. “The goal was to fill a gap in the local continuum rather than duplicate an after-hours service that was being minimally utilized.”
Bollon said 24/7 crisis assessments will be available at both the CCUH and Trinity Hospital Emergency Department. Individuals seen at Trinity will be assessed by Coleman Health Services via telehealth.
“Individuals also can still receive a face-to-face crisis assessment at Rapid Care during business hours as they are currently able to do at SpringVale’s Dover location,” Bollon said.
Even so, Boroski pointed to a growing need for behavioral health and an increase in suicide rates not only nationwide, but also in Tuscarawas and Carroll counties. “The consequences of diminished face-to-face behavioral health crisis service will be vast and far reaching.”
Reactions
Dover Mayor Shane Gunnoe commented after the press event. “I think the Rapid Care model will be very effective during business hours, but a lot of our law-enforcement calls are between six o'clock at night and 7 a.m. I think this is a big step backward during that time.”
Gunnoe also said he and New Philadelphia Mayor Joel Day, along with representatives from law enforcement, met with CCUH earlier this year to express concerns about the current procedures they are using.
“We have a letter to CCUH circulating among the mayors which has gotten six or seven signatures so far expressing concern with the reductions in the mental health area and its impact on our law-enforcement officers who on the front lines of dealing with these issues,” Gunnoe said.
Day agreed losing 24/7 in-person crisis intervention is detrimental to the community. “We’re dealing with more and more mental health issues, particularly our police and fire departments,” he said. “I'm really happy SpringVale is opening the Rapid Care Center. But we need to really confront this mental health problem head on and take it more seriously than just looking at the bottom line and the dollars and cents of it.”
Boroski said the new Rapid Care will conduct a soft opening on Jan. 8 and will share more information after the center is up and running.
If you or someone you know is experiencing a mental health crisis or considering suicide, call the Crisis Care Hotline day or night at 330-343-1811 in Tuscarawas County or 330-627-5240 for Carroll County.