Psychiatry

Department stays ahead of new BH trends

The Department of Psychiatry continues to look at new ways to increase patient access to quality care.

Dr. David Cates, Vice-Chair for Clinical Services in the Department of Psychiatry, says there are a lot of national trends that predict more patients needing psychiatric care.

Dr. Howard Liu, M.D. Chair, Department of Psychiatry

Dr. Cates said SG2, a national healthcare consulting group, published a report in 2018 which projects 26 percent growth in demand for outpatient behavioral health services, including 45 percent growth in Intensive Outpatient Program (IOP) services and 30 percent growth in Partial Hospital (day treatment) care. Also, SG2 projects 10 percent growth in demand for inpatient behavioral health services over the next ten years.

“It is reassuring that many of SG2’s recommended strategies align with the steps that Nebraska Medicine and UNMC have taken or are considering taking, including expanding IOP and PHP services, creating medical-psychiatric inpatient beds, developing ED-based psychiatric services, and embedding behavioral health providers in specialty care clinics,” Dr. Cates said.

Tom Macy, Vice President of Operations at Nebraska Medicine, said UNMC/Nebraska Medicine would continue to increase their ambulatory footprint in both psychiatry and psychology. In 2018, the two partners teamed up to open an Intensive Outpatient Clinic – to treat the dual diagnosis of patients suffering from mental health and substance use disorders. In 2020, Nebraska Medicine will open a Psychiatry Emergency Services (PES) unit.

“The PES (unit) will be an adjunct to the emergency department for patients whose behavioral health issues are at a point where they need to be seen in an emergency setting,” Macy said.

The current projection is that the PES will begin seeing patients on July 1, 2020. It is intended to rapidly evaluate, triage and offer crisis stabilization services to patients, many of whom will not require inpatient psychiatric admission.

David Cates, Ph.D., Vice-Chair of Clinical Services, Department of Psychiatry

“The metaphor is a compassionate train station,” says Dr. Howard Liu, Chair of Psychiatry at UNMC. “The Psych Emergency won’t be the final destination for patients, but it will safely take them where they need to go. It will be staffed by behavioral health professionals and work in partnership with services in the community.”

While opening two new floors in three years sounds like a lot, it’s just a fraction of what behavioral health leadership at UNMC and Nebraska Medicine are considering. Current and future projects under consideration include emergency department-based psychiatric services, partial hospitalization treatment, and IOP programs as an alternative to inpatient admission as well as the creation of a med-psych unit and the growth of interventional psychiatry (ECT, TMS, Ketamine).

Dr. Cates said TMS and ECT are particular growth areas with geriatric psychiatry patients due to drug interactions. National trends point to an almost 60 percent growth in geriatric emergency room visits over the next ten years.

“We are going to continue to expand,” Macy said. “We have plans for more psychiatry services, psychological services, and more counseling services. We want to be prepared for these trends.”

 

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