HOSPITAL BOARDING CRISIS PERSISTS

By Christian M. W ade Statehouse Reporter

BOSTON — Hundreds of psychiatric patients are still being “boarded” in emergency rooms across the state as they await beds in mental health facilities, according to a new report.

The Massachusetts Health and Hospital Association’s report, which surveyed hospitals, found that some patients with severe psychiatric conditions who require “continuing care” services from the state Department of Mental Health have been waiting for more than a year for specialized care.

“Because psychiatric units are unable to transfer patients ready for discharge into DMH continuing care beds, the psychiatric units themselves are unable to accept new patients into the inpatient psychiatric beds,” the report’s authors wrote. “This, in turn, contributes to ‘behavioral health boarding’ in hospital emergency departments and other units.”

The average length of stay awaiting transfer to a continuing care bed is 197 days — an increase from 161 days in 2021, according to the report’s authors.

See BOARDING, Page A6

Continued from Page A1 Leigh Simons Youmans, director of MHA’s heath care policy, said the situation is being driven by workforce and bed shortages and shows how “capacity pressures are reverberating through hospitals and every component of the healthcare system.”

“We are seeing a ripple effect of backups throughout the entire healthcare system,” she said. “The fragility of the state’s behavioral health system means that the inability to place a few hundred patients translates into hundreds of additional behavioral patients boarding regularly in acute care hospitals as they await an inpatient bed.”

Overall, the number of state-funded psychiatric care beds in the state has dropped from 829 to 663 over the past 15 years, adding to the challenges of placing patients, the report noted.

The report recommends that the state expand continuing care capacity for patients discharged from inpatient level of care, use alternative placements such as community- based services and “wraparound” services and do a better job of tracking access to mental health services.

Under state and federal health care guidelines, hospitals cannot use psychiatric beds when there isn’t enough professional staff to oversee them.

Beacon Hill has taken a number of steps aimed at addressing a mental health “crisis” that experts say has been exacerbated by the disruptions and isolation of the pandemic.

A bill signed into law in August by then-Gov. Charlie Baker seeks to expand behavioral health services by requiring insurers to cover annual mental health exams, similar to wellness checks, and cover same-day psychiatric and emergency stabilization care.

State leaders have also made a commitment to spend sizable amounts of money to improve mental health coverage and care.

In 2021, Baker signed a $4 billion COVID-19 relief bill that diverts $400 million to expand mental health care and reduce boarding of psychiatric patients.

But the hospital association says despite the efforts hundreds of patients face sometimes long waits to find available beds in psychiatric facilities.

As of last week, 616 individuals, including 68 children, were being boarded in 52 hospitals awaiting mental health services, according to a weekly tally.

Locally, hospitals in the north of Boston region reported the third-largest number of boarders, with an estimated 120 patients waiting to be transferred.

Christian M. Wade covers the Massachusetts Statehouse for North of Boston Media Group’s newspapers and websites. Email him at cwade@cnhinews.com.