Tri-City Medical Center to reconsider decision to close psychiatric ward

The Oceanside hospital was to shut down its 18-bed locked behavioral health unit next week. (U-T file photo)

With just days to go before it was to shutter its psychiatric ward, Tri-City Medical Center announced Friday afternoon that its board of directors will hear public testimony and take a fresh vote on the matter next week.

The Oceanside hospital was to shut down its 18-bed locked behavioral health unit next week. With the county’s approval, Tri-City already shuttered its 12-person crisis-stabilization unit, which provided up to 24 hours of recuperation time for patients experiencing mental health distress.

During a hastily scheduled special meeting on June 26, Tri-City’s elected board voted unanimously to close both units within 60 days citing regulatory, financial and staffing difficulties. But the Service Employees International Union, which represents many of the 80 mental health employees who received layoff notices after the board’s decision, demanded that the vote be re-taken, alleging that certain aspects of the first meeting two months ago violated public meetings law.

The board’s statement Friday afternoon did not reference the union’s allegations and hospital spokesman Aaron Byzak said they were not the reason for the board’s decision to re-hear the matter on Tuesday at 4:30 p.m.

“Recognizing the community’s concern regarding mental health services, the board decided to provide another opportunity for interested persons to provide testimony. After considering public comments and relevant information regarding the units, the board will decide what — if any — action to take,” the statement said.

It was not clear whether Tri-City could have closed its locked unit next week. The county’s Behavioral Health Services Department sent the hospital’s chief executive a letter on Aug. 6 that said Tri-City must “continue to accept new admissions through Sept. 22” to provide enough time for the public district hospital to “locate and transition inpatient clients to alternative and appropriate level of care beds.”

It’s that transfer that has riled many in coastal North County who have wondered where patients brought in on “5150” holds — people found to be a danger to themselves or others — will go when Tri-City’s unit closes. The nearest units that remain open are at the former Palomar Medical Center complex in downtown Escondido and at the county’s psychiatric hospital on Rosecrans Street in San Diego’s Midway district. Local governments have expressed significant concerns that transportation requirements would take too many law enforcement officers away from the cities where they patrol. And the families of those whose loved ones use the Tri-City units have repeatedly commented on the hardship of driving so far to visit.

Diane Bagby, a director of the North Coastal San Diego chapter of the National Alliance for Mental Illness, and her husband Mike Bagby, who serves as the chapter’s president, said they were cautiously hopeful about the chances that the Tri-City board might reverse its previous decision though the couple said they have struggled to get meetings with hospital leadership to discuss the possibility of just such an action.

“People are upset with the hospital over this decision, that’s for sure,” Diane Bagby said. “I can’t trust that they are willing to start these units up again, but we’ll see.”

In explaining its closure decision to the public, Tri-City has said that it has difficulty finding enough psychiatrists to staff its units. Psychiatrists are required to evaluate whether or not patients need to be admitted for three days or even 14 days of treatment in a locked ward and also are involved in adjustment of anti-psychotic medications.

Danielle Denis, an Escondido resident who said she has been diagnosed with bipolar depression, said she went to Tri-City’s emergency department on Aug. 4, after having suicidal thoughts just one day after Tri-City closed its crisis stabilization unit. She said she and several other female psychiatric patients were kept together in a “fast track” room at the hospital for 48 hours without seeing a psychiatrist. Medical records that Denis provided appear to confirm the timeline of her visit and that she was discharged from Tri-City’s emergency department on Aug. 6. She said she immediately called 911 to report that she was still feeling suicidal and was readmitted to Tri-City’s emergency room and then transferred to Palomar’s locked behavioral health unit where she continues to receive treatment.

Denis said Palomar doctors changed the medications she is taking, and she’s feeling better, but the experience at Tri-City, she said, convinced her that the hospital must do more to bolster its emergency psychiatric capacity.

“They don’t have the staff, and it’s not right what’s going on,” Denis said.

Byzak said in an email that health care privacy law prevents Tri-City from confirming or denying whether Denis was a patient.