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Closing inpatient services at Psych Center would impair Claxton-Hepburn’s ability to function

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OGDENSBURG — Claxton-Hepburn Medical Center’s emergency room chief says the hospital’s ability to serve patients would be seriously damaged by the proposed closure of inpatient care facilities at the St. Lawrence Psychiatric Center.

Because Claxton-Hepburn is the state-designated location for mental health patients in St. Lawrence County to be evaluated before being sent to a psychiatric center, the decision to send patients downstate could overtax the hospital’s capacity to house patients awaiting transportation.

The state Office of Mental Health plans to move child inpatient care to Utica and adult inpatient care to Syracuse, a proposal that has drawn harsh criticism from north country leaders and mental health advocates.

Dr. H. Theodore Klaudt, chief of emergency medicine at Claxton-Hepburn, said the OMH plan would impair the hospital’s ability to take care of its patients – both those with mental health problems and others.

The hospital has three beds in the emergency department designated for mental health patients that are secure and separate. In the rest of the department there are 13 beds.

“We very routinely have more than three mental health patients in our department,” Dr. Klaudt said.

“We’re trying to help mental health patients the best we can,” he said. “When you’re in a lot of psychological distress you don’t want to be in the center of chaos.”

Last year the Claxton-Hepburn emergency department saw 19,000 patients, Dr. Klaudt said; 1,700 of those were experiencing mental health problems. Those patients often take more time to clear than other patients, he said.

Dr. Klaudt said patients who end up being transferred to a mental health facility spend an average of 15 hours and 45 minutes at Claxton-Hepburn.

“The patients who are admitted to our psychiatric unit spend an average of 10.5 hours,” he said, “and the patients who come for a mental health evaluation and then are sent home stay for an average of nine hours.”

That is significantly longer than non-mental-health patients, who average five hours if they are seriously hurt or ill. Most patients who are not seriously injured stay for just over two hours, Dr. Klaudt said.

If there are more mental health patients, “they’re going to stay longer and take up more of our department,” Dr. Klaudt said. “It’s also going to impact the other 17,000 visits, all those other patients who we have a duty and obligation to serve. They’re going to find that things slow down because of space constraints.”

Dr. Klaudt said it’s already difficult to find space for patients at the St. Lawrence Psychiatric Center, with patients occasionally having to be sent to other facilities around the state.

Without inpatient treatment at the St. Lawrence Psychiatric Center, “there is a high likelihood that we’re going to be holding them in our emergency department,” Dr. Klaudt said. “It will be more difficult to find inpatient beds.”

And as they wait for transportation to centers that are farther away, they will be taking up precious room in the already strained emergency department.

“They’re not patients you can leave sitting in the waiting room,” Dr. Klaudt said, noting that suicide risk and other issues require mental health patients to have people observing them constantly.

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