What a difference a year makes. In 2008, the state's Department of Health and Hospitals (DHH) trumpeted the opening of 20 additional psychiatric beds at New Orleans Adolescent Hospital (NOAH). Then-assistant secretary of DHH William Payne spoke of the city's need for more beds: "The occupancy rate at NOAH was 96 percent in 2007. These beds are almost always full."
Now the state wants to close the facility.
In an effort to cut $9 million from the state budget, Gov. Bobby Jindal and DHH Secretary Alan Levine want to move NOAH's beds 40 miles across Lake Pontchartrain to Southeast Louisiana Hospital in Mandeville. When DHH presented its plan to the New Orleans City Council, deputy secretary Cybil Richard disingenuously suggested the change would actually improve mental health services in our area. Transferring NOAH's young patients outside the city takes them away from their families and hurts their chances of recovery.
Besides inpatient services, NOAH also offers outpatient treatment. It thus can immediately provide its outpatient clients with hospital beds in the event of a severe mental health crisis. Staff at the outpatient clinic know local patients and can continue uninterrupted care. Medically, that makes much more sense than transferring patients to St. Tammany Parish, which also takes patients' families out of the healing equation. Many of NOAH's patients come from poor families who lack private transportation; there is no public transportation from New Orleans to Mandeville.
"[The closure] severely affects family interaction," says Dr. Howard Osofsky, chair of LSU's Health Sciences Center's Department of Psychiatry. "And for children and adolescents, that's such a crucial part of their treatment." Osofsky has been on the front lines since Hurricane Katrina, overseeing mental health care for first responders, displaced children and their families, and rebuilding the mental health infrastructure. He notes that because of the storm's unprecedented scale and the slow recovery process, New Orleans has a significantly greater need for mental health services than other American cities.
Ironically, Jindal agreed with Osofsky's assessment — last year. He unveiled a legislative package to improve Louisiana's mental health care system and said, "The broken pieces in our mental healthcare system affect every Louisianan, but the problem is especially acute in New Orleans."
Now the governor proposes taking psychiatric beds out of New Orleans, which will only make matters worse.
Equally ironic, last year Jindal signed Nicola's Law, named after New Orleans police officer Nicola Cotton, who was killed by a known schizophrenic who was not on medication or treatment when he shot Cotton. One of the provisions of that law allows for a mentally ill person who refuses medication to be sent to an inpatient facility. The law protects not only mentally ill people but also the community. But what happens when there are no beds available in New Orleans? Must cops transport a patient to Mandeville, or does a potentially violent person sit in a hospital waiting room until transportation can be arranged by the state?
State officials say one of the reasons for moving the inpatient beds to the Northshore is that the Mandeville hospital can separate children's beds from adolescent beds, which is considered a best practice but allegedly isn't possible at NOAH. Not true. In February, the state closed 10 adult beds at NOAH so it could provide a separate area for children.
Jindal and Levine hope the move will save the state money, but that's unlikely. "Without proper treatment and family involvement, patients are less likely to get better and will require longer-term hospitalization," NOPD crisis unit administrator Cecile Tebo wrote in a Times-Picayune op-ed last week. "Those unable to get proper treatment can end up in jail, part of the overburdened and costly criminal system." State Rep. Neil Abramson, D-New Orleans, adds that closing NOAH will hurt the local economy and cost the city several hundred jobs.
By DHH's own admission, Southeast Louisiana hospital already serves twice as many people from Orleans Parish as St. Tammany Parish. Given those numbers, it would make more sense to move the inpatient beds from Mandeville to NOAH. At a minimum, the governor should heed the observation he made last year — that the state's mental health problems are especially acute in New Orleans — and keep NOAH open.