Cleveland’s Safety Net Hospital Builds 112-Bed Psychiatric Facility

Abstract

Back to table of contents Previous article Next article ProfessionalFull AccessCleveland’s Safety Net Hospital Builds 112-Bed Psychiatric FacilityMark MoranMark MoranSearch for more papers by this authorPublished Online:9 Feb 2023https://doi.org/10.1176/appi.pn.2023.03.3.35AbstractThe new hospital and an enlarged training program mark the largest expansion of behavioral health services in northeast Ohio in 30 years.MetroHealth Hospital in Ohio, founded in 1837, is the safety net hospital for Cleveland and Cuyahoga County, serving more than 300,000 patients, two-thirds of whom are uninsured or covered by Medicare or Medicaid. Last October, the hospital opened the MetroHealth Behavioral Health Hospital to replace the 20-bed psychiatric unit in the old hospital. The Cleveland MetroHealth Behavioral Health Hospital opened last October and will eventually have 112 inpatient beds, cutting the region’s inpatient deficit by more than 50%.Cleveland MetroHealth HospitalThe psychiatry residency training program at MetroHealth received approval from the Accreditation Council for Graduate Medical a (ACGME) to add three new training slots per year, which will increase the total number of residents from 20 to 32. Like the state-funded expansion of the training program at the University of Iowa (see “Iowa Funds Expansion of Rural Psychiatry Training, Services for Underserved Populations”), the developments at MetroHealth are evidence that states and municipalities are responding to the shortage of mental health professionals and the need to invest in expanding the psychiatric workforce. Last November, the Cuyahoga County Council approved the use of $5 million from its Opioid Mitigation Fund to construct the $42 million hospital. The council’s $124 million fund is derived from settlements with opioid manufacturers. According to the U.S. District Attorney’s Office for Northeastern Ohio, the county saw a 1,000% increase in opioid deaths between 2007 and 2016. There were 653 overdose deaths in the county in 2022, according to the County Medical Examiner’s Office. Cheryl Wills, M.D., director of child and adolescent psychiatry at MetroHealth, said the new hospital and the expansion of the training program are the result, in part, of a 2018 needs assessment conducted by the hospital’s strategic team. Taking into account existing resources in the region, the assessment showed that Cuyahoga County was short 200 inpatient psychiatric beds. The new hospital is expanding incrementally—40 adult beds became available when the hospital opened in October. Separate 20-bed units for adolescents, patients with substance use disorders, and geriatric patients are expected to open this year.Cleveland MetroHealth Hospital“MetroHealth has a rich history of serving all people, regardless of ability to pay,” said Wills, who is also APA’s Area 4 trustee. “But we were consistently referring people out for mental health treatment because we had only 20 beds. By expanding with the new hospital to 112 beds, we are addressing 50% of the deficit, a huge step.” Raman Marwaha, M.D., the residency training director at MetroHealth, said the developments there mark the largest expansion of behavioral health services in northeast Ohio in 30 years. “When I joined MetroHealth eight years ago, I had a waiting list of 18 months,” said Marwaha, who is president of the APA Caucus of International Medical Graduates. He said the new hospital is moving incrementally toward reaching the total of 112 beds—40 adult beds became available when the hospital opened last October, and at press time a psychiatric-medical unit and a four-bed psychiatric intensive care unit were expected to open. “The plan is in the next six months to open more beds—a 20-bed adolescent unit, a 20-bed addiction unit, and a 20-bed geriatric unit.” Marwaha said that residents in the expanded program, which will be located at the new hospital, will have training rotations in schools, integrated group practices, and the county correctional facility. Attracting residents and, importantly, faculty to help supervise residents is critical. Wills did some detective work and discovered an Ohio state loan repayment program for which physicians who work at MetroHealth would qualify—a lesson, Wills said, for other institutions and localities. “It’s important to think creatively and strategically and to learn about existing available resources,” she said. “When I started at MetroHealth in March last year, one of my concerns was recruitment of the best faculty possible. I felt we had to have something to offer people, to make it attractive to work here. We are hoping to attract psychiatrists invested in working with underserved and safety net populations who will be involved for the long haul.” ■Ohio Physician Loan Repayment ProgramThe Cuyahoga County Medical Examiner’s Report on opioid deathsCuyahoga County Opioid Mitigation FundHeroin Epidemic, U.S. Attorney’s Heroin and Opioid Task Force ISSUES NewArchived