Northwest Arkansas and the River Valley need more inpatient psychiatric beds, according to local health leaders and community organizations.
There are 286 inpatient psychiatric beds in Washington County, some of which are reserved for certain ages or people who have served in the military. There are none in Benton County.
"The demand for inpatient behavioral health services is growing, commensurate with the general population growth we're seeing in Northwest Arkansas," said Christina Bull, spokesperson for Northwest Health.
The primary need for inpatient psychiatric services in Northwest Arkansas is for mental health beds dedicated to child, adolescent and geriatric patients, though adult care could be better as well, according to Dr. Aaron Carson with the University of Arkansas for Medical Sciences Psychiatry Clinic in Fayetteville.
The increased numbers of patients with issues related to trauma, stress and substance abuse from the covid-19 pandemic continue to need more providers, according to Carson.
"The population has outpaced our resources," he said. "We've had a high demand for care across the region."
Sebastian County has 137 inpatient psychiatric beds.
Crystal Lougin, director of behavioral health at Baptist Health Fort Smith and Van Buren, said there is a general need for more inpatient hospitalization opportunities for child and geriatric patients in the River Valley as well.
Arkansas ranks 45th among U.S. states in access to mental health care, according to the nonprofit Mental Health America. According to the organization's October 2022 report, 230,000 Arkansans with a mental illness did not receive any treatment during the previous year.
The number of psychiatric beds in the United States has dropped significantly the last 60 years, and a lack of access to treatment can lead to homelessness or involvement in the criminal justice system, according to the American Psychiatric Association.
Assessing the necessary number of psychiatric beds in a given region is complex because it is impacted by the availability of other services, according to a May 2022 report by the association.
The region also needs additional outpatient services, which are used by both patients transitioning out of inpatient care as well as those who have not needed inpatient treatment, said Jordon Babcock, chief executive officer of Springwoods Behavioral Health. A waitlist for such services can last months, he said.
"If you have more access to outpatient care, it can reduce the need for inpatient care," Lougin said. "You're looking at preventative care in that regard."
Ryan Cork with the Northwest Arkansas Council, a nonprofit organization with members from the region's largest business, education and health care organizations, said responses to the council's recent mental health care survey indicated access to care is lacking.
BARRIERS TO CARE
Affordability may be an issue as well.
The federal Substance Abuse and Mental Health Services Administration found in a report from a 2020 national survey cost was the most common reason Americans did not receive mental health services.
Next to child care, mental health care was reported as one of the least affordable essential services, according to a 2021 national survey by management consulting firm McKinsey & Co.
Among Arkansans enrolled in large employer health plans, adults with a mental illness averaged higher out-of-pocket spending than adults without mental illness, according to 2021 data analyzed by the nonprofit Kaiser Family Foundation.
Some community organizations have said it can be difficult to find inpatient care for people experiencing a mental health crisis.
"It's kind of like an alignment of the stars," said Debbie Rambo, executive director of Samaritan Community Center in Rogers. "For a lot of families, the lack of inpatient facilities is pretty stifling. That has societal woes. They start missing work, then lose their job and then lose their housing."
One in five Americans experiences a mental illness, and one in 25 Americans lives with a serious mental illness like schizophrenia, bipolar disorder or depression, according to the federal Centers for Disease Control and Prevention.
Dr. Upton Siddons, family doctor with Baptist Health Family Clinic in Greenwood, said mental health care addresses a common need, albeit one brought about by everyday stressors, life experiences and family histories.
People diagnosed with serious mental illnesses may need inpatient behavioral health treatment, where they can stay in a safe and separate environment for several days. A common criteria for inpatient psychiatric care is that the patients are at extreme risk of harming themselves or others, according to Lougin.
Inpatient behavioral health programs like the one at Northwest Medical Center in Springdale are intended to help those experiencing mental health crises that have left them unable to safely care for themselves, Bull said. The length of stay and the specific care will vary between individuals, but the goal is to help each person recover and return to the community or a lower level of care, she said.
NWA FACILITIES
Northwest Medical Center is the only acute care hospital in the area with an inpatient psychiatric unit. The unit opened with 15 beds in 2009 and has expanded several times over the years. Its 77 beds saw more than 1,600 patients in 2022, according to Bull.
The unit is currently 90% full and consistently maintains a high occupancy, she said.
Springwoods Behavioral Health in Fayetteville has had 80 beds since 2009, according to Babcock. Half of the beds are reserved for adolescents – ages 12 to 17 – and half for adults, he said.
Springwoods saw an estimated 2,000 patients last year through its inpatient services, which are running at about 75% capacity, he said.
The facility sees "pretty heavy demand" for inpatient services and sometimes has a waitlist for adolescent beds during the school year, he said.
Springwoods has seen increased demand in the areas of substance abuse and adolescent care in recent years, he said. Its psychiatric emergency room last year saw three times as many patients for substance abuse compared to 2018, he said.
Vantage Point Behavioral Health Hospital in Fayetteville has 114 beds, according to the state Department of Health. The beds are available for ages 5 and up, the facility's website states.
A Vantage Point representative declined to speak about the facility. Acadia Healthcare, the company that owns Vantage Point, did not respond to calls.
Veterans Health Care System of the Ozarks has a behavioral health unit with 15 beds reserved for veterans in its 22-county coverage area.
The Fayetteville behavioral health unit has recently seen an average daily patient population of five people, which is representative of last year, though that number can be deceiving, said Dr. Reba Glidewell, associate chief of staff, mental health service. Sometimes the beds have been nearly empty while they have all been full at other times, she said.
The Northwest Arkansas Crisis Stabilization Unit, a partnership between Washington County and the University of Arkansas for Medical Sciences, is an alternative to inpatient psychiatric hospitals, emergency departments and jails, according to program Director Kristen McAllister.
The unit, one of four crisis stabilization units in the state, has 16 beds for people experiencing behavioral health crises.
The crisis stabilization unit receives people from inpatient units and may transfer someone to inpatient psychiatric facilities if their condition worsens, she said.
RIVER VALLEY
Baptist Health Fort Smith is the only geriatric inpatient psychiatric unit in the River Valley, according to Lougin. The facility opened in 2003, and its 23 beds are reserved specifically for people 55 and older, she said.
The unit admits 45 patients a month and averages about 18 patients staying in the unit each day, she said. There is typically not a waitlist for the facility, she said.
The facility saw a decline in patients about eight months into the pandemic and is just beginning to see a return to pre-pandemic numbers this year, Lougin said. The numbers do not necessarily indicate a decline in need for services, she said. Many of the facility's referrals come from assisted living centers and nursing homes, many of which were not sending out patients at the time but have since resumed.
Valley Behavioral Health System in Barling has 114 beds, according to the state Health Department. A representative of Valley Behavioral, which is owned by Acadia Healthcare, declined to comment.
The Sebastian County Crisis Stabilization Unit in Fort Smith, an alternative to inpatient psychiatric units, has 16 beds.
PIECES OF THE PUZZLE
Health care providers and community organizations are aiming to address the demand for mental health care in a variety of ways.
At the University of Arkansas for Medical Sciences, Carson is leading an effort to begin a psychiatry residency for medical students in Fayetteville. Retaining and recruiting psychiatrists has been a national issue to which the region has not been immune, he said.
The goal is to start the residency in 2025, though that timeline is not certain, according to Carson.
Veterans Health Care System of the Ozarks is building a new 20,321-square-foot facility for inpatient behavioral health. The $13 million building, scheduled to open this fall, will provide a better layout and facility for the VA's inpatient care, but will not expand its capacity, according to Glidewell.
A mental health counseling center with providers and student interns will be a part of the Samaritan Community Center's new 41,000-square-foot facility in southeast Rogers, according to Rambo. Inpatient care will not be a part of the counseling center. Services at the counseling center not covered by Medicaid will be charitable care, she said. The construction project is planned for completion in September, she said.
Springwoods Behavioral Health is looking at expanding with two new outpatient locations in Northwest Arkansas, Babcock said.
The Northwest Arkansas Council is in the early stages of working with the University of Arkansas' McMillon Innovation Studio with hopes of creating an inpatient psychiatric bed dashboard.
Cork, executive director of the council's health care transformation division, said he has heard a story about a health care provider having to make 90 calls before finding an available bed in a behavioral health unit.
Judd Semingson, chief executive officer of Springdale-based Community Clinic, said he expects the inpatient psychiatric bed dashboard to help clinicians.
"There is a need, and I don't think it's going to be one piece of the puzzle that any of us solves," he said.
Ryan Staggs, health care engineer, and April Eilers, public affairs officer, (left) visit Friday April 14, 2023, during a tour of a new 20,321-square-foot facility for the Veterans Health Care System of the Ozarks 15-bed inpatient behavioral health unit. The $13 million building, scheduled to open this fall, will provide a better layout and facility for the VA's inpatient care, but will not expand its capacity, according to Dr. Reba Glidewell, associate chief of staff, mental health service. Northwest Arkansas and the River Valley need more inpatient psychiatric beds, according to local health leaders and community organizations. There are 286 inpatient psychiatric beds in Washington County, some of which are reserved for certain ages or people who have served in the military. There are none in Benton County. Visit nwaonline.com/photo for today's photo gallery. (NWA Democrat-Gazette/J.T. Wampler)
One of inpatient behavioral health room at Northwest Hospital in Springdale. (NWA Democrat-Gazette/SPENCER TIREY)Mental and behavioral health in Arkansas
Members of the Arkansas Legislature are conducting an ongoing study of the strengths and weaknesses of the states mental and behavioral health care.
The Arkansas Legislative Study on Mental and Behavioral Health, established by Act 802 in 2021, will lead to policy recommendations to the General Assembly.
The timeline for the study was extended by the recently signed Act 512 of 2023, which determined that the committees involved in the study will continue the study and submit a final written report no later than Oct. 31, 2024.
Recommendations in the report will be considered by the legislature during the 2025 regular session, according to the law.
The House Committee on Public Health, Welfare, and Labor and the Senate Committee on Public Health, Welfare, and Labor are studying access to and availability of mental and behavioral health care in Arkansas; existing mental and behavioral healthcare facilities in the state; Medicaid programs regarding mental and behavioral health and other public and private medical reimbursements for mental and behavioral healthcare providers and facilities; best practices for provision of mental and behavioral health services; mental and behavioral health programs in other states; the utilization and financial condition of the crisis stabilization units and the Arkansas State Hospital; transportation of mental and behavioral health patients in Arkansas; the rate of deaths by suicide of school-aged children in the state; mental health screenings and suicide prevention measures for children in kindergarten through high school; and other matters related to mental and behavioral health services.
Source: NWA Democrat-Gazette