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Outpatient mental health services become high priority if Ogdensburg loses inpatient psychiatric care

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OGDENSBURG — Health providers and advocates are worried about how north country patients will be able to get the mental health care they need through outpatient programs when inpatient treatment is no longer provided at the St. Lawrence Psychiatric Center.

Bolstering outpatient care emerged as a top priority during a gathering last week in Syracuse of state and St. Lawrence County officials as they prepare for the Office of Mental Health directive to consolidate inpatient care in regional facilities. OMH has proposed moving the Ogdensburg center’s adult inpatient services to Syracuse starting next year and its children’s services to Utica starting in 2015. The plan, based partly on the idea that the state’s mental health system is antiquated in its reliance on inpatient care, calls for greater emphasis on community support services and designates Ogdensburg as a community service hub.

“As much as I understand the importance of community-based services ... I still am struggling with figuring out what it is that I can do in rural, upstate New York and St. Lawrence County if spaces for children, in particular, are not available,” said Angela M. Doe, St. Lawrence County community services director. “What I’m the most concerned about is losing that level of care and replacing it with the ‘potential’ of community-based services.”

A Broome County official warned against assuming that community-based care will pick up the slack.

“In Broome County, the county jail is the largest mental health provider in the county,” said Art Johnson, county director of community services. “One hundred fifty beds every day of the week are occupied by mentally ill individuals who are being prescribed medication by their psychiatrist.”

Unless the state wants more mental health patients to end up in jail, outpatient and community-based programs must be adequately funded, he said.

Vicki E. Perrine, chief operating officer of Claxton-Hepburn Medical Center who co-chairs the Regional Excellence Team put in place to help formulate the mental health care transition, said local hospitals will be affected by the shift to outpatient care unless new services are put into place quickly.

“I think that once you pull out the children’s inpatient services, from a hospital perspective, one of our main concerns is that we’re going to see more children” in the emergency room, Ms. Perrine said. “It’s difficult to find beds when they do need services, and they stay there for days. We’ve had some for weeks. But again, I’m on board with what we’re doing here and am hopeful that we are going to get some services out in the community that will prevent folks from needing hospitalization.”

The regional team will meet one more time before delivering its recommendations in late fall to a steering committee, which later will report to the OMH commissioner to finalize the plan to restructure mental health care in the state.

Meanwhile, north country advocates say their fight to preserve inpatient care at the St. Lawrence Psychiatric Center is not over.

“They’ve got three or four months of meeting, then they come up with a game plan and present it to the higher-ups,” said Charles W. Kelly, chairman of the St. Lawrence Psychiatric Center Task Force. “Then it becomes a real issue.”

The task force hopes to meet with Gov. Andrew M. Cuomo in December to make its case. “We’re going a step higher,” Mr. Kelly said.

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