FMH changes how it provides psychiatric care as diagnoses increase [The Frederick News-Post, Md.]

Oct. 19--Frederick Memorial Hospital is taking a new approach to handling the increasing number of psychiatric cases that come into the emergency room.

On Oct. 1, the hospital ended its long-standing contract for behavioral health services with Sheppard Pratt Health System and started providing those services through its own hired medical staff. The hospital wanted to contract directly with the psychiatrists, said Mary Beth Mann, assistant vice president for patient care services.

The change does not reflect badly on Sheppard Pratt, which had been under contract for more than a decade, but is in keeping with the hospital's move toward closer relationships with the service providers, she said.

"The closer you can work with your team the better," Mann said. "We had a very good, positive relationship (with Sheppard Pratt)."

The hospital hired the head of its department from the doctors Sheppard Pratt had under contract at the hospital. The hospital has two other psychiatrists on staff, and plans to hire a fourth, Mann said.

The hospital offers three levels of care for behavioral health patients after a diagnosis: release with a referral to a family doctor for follo-wup, release with assignment to therapy sessions, admission to one of the hospital's 21 beds assigned for behavioral health, or transfer to a pediatric facility or detoxification treatment.

Since 2005, Mann said the number of emergency room visits each year that required a psychiatric evaluation has gone up almost steadily, except for a dip in 2009, from 400 to 2,500 last year. This year is on track to have more than 2,500, she said.

During that time, major depressive disorder and bipolar disorder accounted for 45 percent of the diagnoses. The economy may have something to do with the increase, she said, particularly as job insecurity or layoffs may increase anxiety and cut back on insurance coverage.

The hospital's strategic plan includes more behavioral health options, eventually to include weekend and evening services, Mann said.

"There's a dramatically growing need," said Harry Grandinett, director of marketing and communications.

Follow Patti S. Borda on Twitter: @FNP_Patti

Types of cases in FMH behavioral health department since 200523 percent major depressive disorder22 percent bipolar10 percent delirium7 percent dementia6 percent anxiety

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