One of Brevard’s only mental health crisis units about to close amid care shortage

One of Brevard County’s only mental health inpatient units will shut down this month, a move that could put additional strain on the area’s flagging resources at a time when experts say mental health crises are on the rise.

Rockledge Regional Medical Center will close it’s dedicated, 24-bed behavioral health inpatient unit and no longer accept Baker Act patients after April 20, hospital spokeswoman Cathy Pague told FLORIDA TODAY in an email.

Pague said the hospital has partnered with Circles of Care and Palm Point Behavioral Health, which run the county’s only other two mental health crisis units, to “transition care of current patients and to ensure the Brevard community has access to the vital care it needs,” she said in a statement.

The Florida Health Care Act of 1971, commonly called the “Baker Act,” allows individuals dealing with acute mental health crises who are a danger to themselves or others to be involuntarily held and examined for up to 72 hours.

It was unclear Friday what prompted the move to close the facility, although local providers and advocacy groups said the unit could be hampered by financial shortfalls ubiquitous to mental health providers around the state. Pague did not immediately respond to questions about why the hospital was closing the unit.

Sources who spoke to FLORIDA TODAY were reluctant to comment directly on the decision by the hospital, which is run by Steward Health Care. The group describes itself as “the largest private, tax-paying hospital operator in the country,” according to its website. It operates 39 community hospitals across nine states and the country of Malta, the website said.

Nevertheless, some expressed worries that the move could exacerbate a shortage of mental health resources in the county, which are already struggling to meet the needs of residents.

“In general, there is a lack of services for mental health in our community — and in the state for that matter — so when a service goes down there’s always a concern,” said Johnette Gindling, president and CEO of the Space Coast Health Foundation.

The unit at Rockledge was one of only three inpatient mental crisis units in the county capable of receiving Baker Act patients. It will largely fall on Palm Point in Titusville and Circles of Care, which is based in Melbourne, to pick up the slack, leaving Central Brevard without its own inpatient crisis center.

“It is an unfortunate loss for the central part of Brevard,” the Brevard Health Alliance said in a statement, issues through spokeswoman Alicia Moore.

“There are limited resources for mental health services in Brevard. That fact is even more apparent when looking at the uninsured and underinsured, which are a part of Brevard Health Alliance’s target population,” Moore said. “Our perspective is we do the best we can for our patients with the resources available.”

Much of the problem comes down to funding, Gindling said. Florida consistently ranks among the bottom in state spending on mental health resources. Many patients with acute mental health needs are low-income, and even when they do have insurance or Medicaid, those programs are often reluctant to pay for the full costs of treatment.

The Space Coast Health Foundation currently loses $20 on each of its outpatient counseling sessions, which are reimbursed mainly through Medicaid, Gindling said. 

Low reimbursement rates have caused chronic problems with staffing and the availability of therapists and other mental health professionals across the state, who will often choose to open shop elsewhere rather than face the prospect of losing money, she said.

“We have a monthly task force called the behavioral health task force, and we have a lot partners at that table,” Gindling said. “And I can tell you right now that every single one of them has a waiting list and every single one of those services has a shortage of staff.”

The closing of the unit at Rockledge Regional Medical Center comes at a time when mental health issues are on the rise around the county. 

According to Space Coast Health Foundation spokesman Wayne Price, a community needs assessment report commissioned by the foundation found that between 2016 and 2019:

• The number of Brevard residents experiencing fair to poor mental health jumped from 11.3% to 16.2%.
• The percentage of people diagnosed with a depressive disorder rose from 17% in 2016 to 24.3% in 2019.
• The percentage of residents experiencing symptoms of chronic depression rose from 26.3% to 34.2%.
• Over 9% of residents reported not being able to get mental health services, up from 3.2% in 2016. Cost and lack of insurance were the main reasons given. 

The latest version of the report is set to release next month, Price said. 

“I fully expect that we’re going to see a rise in (the need for) behavioral health services, and that’s mainly because of the other indications from the pandemic,” Gindling said of the pending update.

Tonya Dix, vice president of quality and clinical operations for Circles of Care, confirmed Thursday the organization was in talks with the Rockledge hospital to take over the care of some patients, but there was no indication yet of when or how many the hospital would ask them to receive.

Circles of Care has locations throughout the county, including two inpatient hospital units totaling 52 beds, a 52-bed crisis stabilization unit and a 16-bed children’s unit, Dix said.

“We’re happy to help our community partner out however we need to, and if that means having patients transferred from up there down to our facility, then absolutely we will step up when they are prepared and ready to send us those patients,” Dix said.

Dix was optimistic they could absorb whatever additional ongoing patient care that would result from the closing of the unit, but said making the accommodations could prove to be a challenge.

“We’ll just have to cross that bridge when closer to time,” she said. “Their’s is a fairly small unit. … We will do what it takes to accommodate the patients. We just have to get it figured out.”

This article first appeared in Florida Today