Originally created 05/13/05

New plan sought for crisis unit



After hearing strong objections from doctors and staff about creating a crisis unit in Augusta, the Augusta Community Mental Health Center's governing board agreed Thursday that a better plan is needed.

The latest proposal from the state Department of Human Resources for a 16-bed unit at the mental health center is underfunded, understaffed and underplanned and doesn't make sense, according to most center officials.

With the additional burden of treating people in need of psychiatric stabilization or drug and alcohol detoxification, many psychiatrists and other staff members would leave, said Phil Horton, the center's former interim director.

"We have an outstanding staff, but we are stretched so thin, I don't see how they can do it," he said.

Dr. Horton noted that most crisis patients come in after 5 p.m. and many are suffering from acute physical illnesses in addition to mental illness.

"I am the only physician that's an internist," he said, adding that he would be called day and night to diagnose and treat those patients.

The unit would need a laboratory and X-ray equipment, he said.

"The cost of medications are going to be prohibitive," he said. "We are going to be dealing with significant problems."

One major problem is that the current staff is not trained to keep patients in seclusion or in restraints.

"The concept of a (crisis unit), I support," Dr. Horton said. "But this is woefully underfunded and not well thought out. If we're going to do this, we're going to lose half our medical staff. To a person, we are opposed to this."

Patrick Waters, the center's behavorial health manager, said the center was not asking for the unit but was being asked to run it by the state because East Central Regional Hospital, formerly Georgia Regional, is downsizing July 1.

"The question is, 'Where are these people going to go?' The answer is, 'Nowhere,'" Mr. Waters said. "The state wants a Crisis Stabilization Unit. They've talked to other community service boards and have determined we're the best equipped to do this. We're going to be dealing with these clients one way of another."

Lynn Tyson, a staff psychiatrist, said it made no sense to her that nearby East Central Regional is equipped to handle patients in crisis but the state is cutting beds there and asking the mental health center to do that job.

"Why? Why, when we have a functional hospital over there, they want us to start another hospital?" she said. "We're not only going to be dealing with psychiatric issues, we're going to be dealing with medical issues."

Dr. Tyson said she is concerned it is a cutback by the state that center officials should fight.

"We need to stop it," she said. "I don't think we should play into it."

Board member Ralph Herndon questioned whether Georgia Regional would assign the worst-case patients to the center.

"I, too, am a little afraid of medical conditions that come in and are admitted to us, and we're not able to take care of them," he said.

Board Chairwoman Stella Nunnally questioned why the state is cutting beds but not staff at East Central Regional.

"I really don't know how this would work if they're going to keep their staff, and we're going to do their work," she said. "I feel like the hospital should be the ones taking care of the patients instead of us."

Executive Director Charles Williamson said center officials need to take another look at the proposal because it would have too severe an impact on the medical staff.

"We don't want to dive into something that will put us in jeopardy," he said. "If we're going to do it, we want to do it right."

Reach Sylvia Cooper at (706) 823-3228 or sylvia.cooper@augustachronicle.com.

At the 6 p.m. board meeting May 24, Executive Director Charles Williamson will update the board on efforts to improve the proposal for a crisis unit at the Community Mental Health Center of East Central Georgia.