Right Care, Right Place: Bringing Mental Health Care to the Community

From its main campus in Belmont, serving the mental health needs of the communities of Massachusetts has long been a part of the mission of McLean Hospital. Since 2000, it has expanded its commitment to improve access to care through its Community Hospital Psychiatric Services Program.

“Through this program, McLean clinicians are bringing clinical expertise to the community hospital setting,” explained Christine Tebaldi, MS, RN, NP, director of Community Hospital Psychiatric Services for McLean. “By partnering with our colleagues in emergency departments at community hospitals, we are providing immediate access to psychiatric care where there may have been none previously.”

McLean’s first foray into working hand in hand with community hospitals began 12 years ago at Jordan Hospital in Plymouth, with McLean clinicians being onsite or on call in the emergency department (ED) to provide thorough psychiatric evaluations.

“This program was instrumental in facilitating patients receiving the correct level of care for their illness and allowed patients and families to access mental health care quickly,” said Richard Silva, McLean’s operations director for the southeast region of Massachusetts. “McLean offers them onsite clinical expertise in psychiatry and the support of more experienced clinicians and psychiatrists, if needed.”

According to Tebaldi, in addition to providing greater access to care, the program had a secondary side-effect—providing an easier flow of all services within the ED. “Psychiatric evaluations conducted in EDs can delay patient discharge by hours or days, depending on the complexity of the case,” said Tebaldi. “However, patients in EDs staffed by McLean are seen in the most efficient and effective manner, thus reducing wait times and helping hospitals reduce their ED lengths of stay.”

“Overall, in Massachusetts and across the country, there is a trend of overcrowding and longer lengths of stays in emergency rooms for patients waiting to be seen for psychiatric evaluations,” added Silva. “This is one of the things we are working with local emergency departments to rectify and we are seeing progress.”

The success at Jordan paved the way for implementation of a program at Winchester Hospital’s ED four years later, and since then, McLean’s Community Hospital Psychiatric Services Program has expanded to cover additional community hospital EDs in Eastern Massachusetts. Each ED is staffed by independently licensed psychiatric clinicians who ensure that quality care is available around the clock. The McLean team also offers staff education and assists with policy development on how to deliver psychiatric services in a community hospital setting.

“We are in the EDs ensuring that people in crisis are able to be seen and evaluated as soon as possible,” said Tebaldi. “But we’re also there providing guidance and expertise for our colleagues within the hospital. This program works because it’s a true partnership between McLean and the community hospitals. Together, we are improving clinical services.”

Since the program’s inception, McLean staff working in community EDs have provided care for more than 70,000 individuals and families, averaging approximately 6,000 encounters annually.

“It is gratifying to be involved with these community-based programs because each and every day we’re seeing the positive impact McLean is having on our communities,” said Silva. “McLean has an obligation to the people in our communities, and we are dedicated to providing the best behavioral health care available.”