When police found Ryan Smith in the midst of a manic episode outside his Darby Township apartment in February, they took him to the crisis center at Crozer-Chester Medical Center. There, Smith, a 38-year-old writer diagnosed with bipolar disorder about two decades ago, was assessed and prepped for hospitalization.
But Crozer’s for-profit owner, Prospect Medical Holdings Inc., is currently planning to shut down the crisis center as well as most mental and behavioral health services in the system.
“I don’t know where they would send us in a crisis,” said Smith, who was transferred to Belmont Behavioral Hospital, where he remained for about two weeks.
Crozer Health, a system of four hospitals in Delaware County, has struggled for years. In October, Prospect Medical Holdings installed sales signs at properties. Since then, Crozer has announced service cuts and layoffs.
» READ MORE: Delaware County Memorial Hospital in Crozer will lose more services by the end of May
Last month, WHYY reported that Crozer planned to close most of its mental and behavioral health units in June. Delaware County Memorial Hospital in Drexel Hill will lose its substance abuse outpatient clinic on June 10. Crozer-Chester will close its inpatient substance abuse unit on June 11 and its crisis center and all outpatient mental health and addiction services at the Community Campus on June 19.
Despite the announcement, Kevin Spiegel, Crozer’s chief executive, hopes the services can stay open — provided the county increases its reimbursement to the system for them.
Crozer County and Delaware leaders will meet next Tuesday. According to Delaware County Board Chairwoman Monica Taylor, there are still unanswered questions about Crozer’s finances that she hopes to get answered at this meeting.
But already some units have been closed for months and patients have been asked to seek treatment elsewhere.
Crozer employees, elected officials and patients fear that if Crozer continues with the planned closure of these services, people seeking mental or behavioral health treatment in Delaware County will be left with even fewer options at a time when many people are struggling with a pandemic. issues.
Peggy Malone, president of the Crozer-Chester Nurses Association and nurse in the psychiatric inpatient unit, predicts emergency departments will be overwhelmed and patients will suffer. “Our emergency rooms already have fewer staff on each shift,” Malone says, “and now we’re going to tax that system by putting our patients in crisis of mental illness who need special observation there. It is extremely dangerous for these patients.
Malone has worked at Crozer for 33 years and has spent the past five years in the inpatient substance use disorder unit at Crozer-Chester. She says the unit has been closed since December and was recently reassigned to an inpatient unit which is one of the few mental health services that Crozer is not closing.
The closures, Malone says, will impact providers’ ability to provide ongoing follow-up and care. “A lot of our psychiatric patients come through our outpatient clinics, and they get their medication and their therapy and see their counselors through that. They take away all those services,” she says. “All we will have is a unit to put them in for immediate care.” After their release, they will have to find other care.
Rachel Rubinstein, a 32-year-old insurance representative from Brookhaven, has suffered from depression, agoraphobia and severe panic attacks since childhood. Since 2018, she has had weekly therapy and sees a psychiatrist every two months for medication management at Crozer’s outpatient clinics in Chester.
On April 25, Rubinstein says, she was virtually attending her weekly therapy session when her therapist told her the practice would close on June 19. “My first thought was ‘Oh my God, what am I going to do? “” Rubinstein recalls
In addition to his outpatient clinic appointments, Rubinstein has visited the crisis center in the past. and called during panic attacks when she was alone and felt unsafe. “The people there who answer the phones, the social workers, actually do a great job of deterring you.”
For two weeks, Rubinstein has been looking for a therapist and a psychiatrist. As someone working on Medicaid, she struggles even more than someone with private insurance and a flexible schedule. “Finding a therapist on Medicaid has always been a struggle. Finding a therapist on Medicaid who can accommodate someone who is working is even harder,” she says.
The loss of Crozer’s services comes at a time when demand for behavioral and mental health services has exceeded supply in the area. In the Philadelphia area, a pre-existing mental health backlog has been exacerbated by increased demand due to pandemic stressors.
READ MORE: Philly area has few beds for behavioral health patients — and intense demand
It also comes at a time of upheaval for regional healthcare facilities and their patients. In the past few months alone, two Tower Health hospitals in Chester County have closed, and the US Department of Veterans Affairs is proposing to close two hospitals in Coatesville and University City.
In April, Delaware The county council passed an ordinance requiring Prospect to give 180 days notice of closing services. Taylor, chairman of the board, says that in the past, nonprofit hospitals have worked with the county on transition services. Prospect has “just cut programs and is not working in any way to transition these people into other programs or support them through this transition,” she says.
In addition to conversations with Crozer, the county has worked with other providers to expand existing programs and create new ones as an alternative to those Crozer is closing. Taylor is also waiting to hear if the reported negotiation between Prospect Medical Holdings and ChristianaCare, Delaware’s largest health care system, could lead to a sale.
It’s unclear if any of these alternatives will be ready in time to ensure Crozer’s current patient care isn’t interrupted if a resolution isn’t reached.
A few months after his manic episode, Smith says he is doing better. He believes he is on the right medication regimen, but it is difficult to find the support he needs. “It’s hard to get good help if you have a mental illness in Delaware County.”