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In November 2018, Massachusetts residents will vote on ballot Question 1, a proposed law that would limit how many patients could be assigned to each registered nurse in Massachusetts hospitals and certain other health care facilities. This will be devastating for behavioral and mental health facilities. Concerned by the negative impact that this proposed law would have on overall patient care, McLean has come out publicly in opposition to Question 1.
Reasons behind this opposition are detailed in a recently issued statement from McLean Hospital and a white paper prepared by the Massachusetts Association of Behavioral Health Systems. Individuals in the McLean community are also speaking publicly about why they oppose Question 1. We will be featuring these narratives during the weeks leading up to Election Day voting on November 6, 2018.
My decision to vote against Question 1 is based on my firsthand knowledge that quality care depends on a balanced team of highly trained, skilled, and compassionate professionals. I learned this over many years as I watched my children struggle to find the appropriate psychiatric care for their conditions. In all, my 15-year-old son and my 20-year-old daughter have been hospitalized more than 25 times for psychiatric issues. Fortunately for us, we eventually found the right care at McLean Hospital in Belmont and the McLean-Franciscan Child and Adolescent Inpatient Program. My children have benefited from the rigorous training and consistency of approach involving McLean’s psychiatrists, nurses, social workers, front desk staff, admissions people, even the security staff.
As a parent, having gone through the pain of seeing my children struggle with not being able to find the appropriate health care, I have become a tremendous supporter of McLean’s approach and a strong advocate for improving the standard of care for all mental health patients.
This brings me to my concerns about Question 1. One of my main worries is that funding for Question 1, if it passes, would take away from the critical supports that mental health patients now have through the state’s Department of Mental Health. A tremendous amount of money would have to be spent to pay to institute the dramatic staffing changes required by the new law. I’m not sure how this would be paid for, but it would probably end up coming back to us, the taxpayers—and it could affect mental health funding. The lack of clarity around Question 1’s funding is troubling.
In addition to funding questions, I don’t believe that Question 1, as worded, is the right way to address staffing issues in our health care system. Again, from my experience as a health care professional and my experience with my children, I know that effective care requires a balanced, multidisciplinary team, including doctors, nurses, social workers, and frontline staff. Nurses are an important part of those teams, but they are only a piece. Some cases may require increases in nursing staff. Other cases may not.
Staffing is a complicated issue, and I know that there are nursing shortages at small, community-based hospitals. Still, I do not believe that imposing a global mandate to address staffing issues, as proposed by Question 1, is the right approach. I believe that staffing shortages must be addressed case by case in specific settings.
The health care professionals that I speak with in my work also feel this way. If the people in the field who I support and care about are not supporting Question 1, I’m listening to them. I hope you will too.
Kate Maffa, PT, MS, is mother to her 15-year-old son and 20-year-old daughter, who were treated at McLean Hospital on our Belmont campus and at the McLean-Franciscan Child and Adolescent Inpatient Program.