Needed mental health care at Fairfax Hospital

With mental health care going down the drain all across Washington for the past several years - with inpatient beds decreasing and funding getting slashed - one private, for-profit psychiatric hospital in the quiet suburbs of Kirkland rose above it all. Fairfax Hospital, of Psychiatric Solutions, Inc. is the only facility of its kind in the state and has been a remarkable example of what should be done to provide for some of the most suffering members of society.

"Fairfax Hospital is providing a service that very few other hospitals provide," said Cassie Sauer, vice president of communications for the Washington State Hospital Association (WSHA). "They provide a full range of mental health facilities - which is very rare."

Founded in 1930, Fairfax Hospital has been a leader in mental health care for decades. Originally built in Seattle, Fairfax moved to Kirkland in 1938, where it began receiving more patients and psychiatrists until it became a full-fledged hospital dedicated to serving the needs of the entire Puget Sound area.

In 1972, it was purchased by Community Psychiatric Centers (CPC) where it then added programs and services for children and adolescents. Finally, Fairfax was purchased by Behavioral Healthcare Corporation (BHC) in 1996, where it started The Northwest School of Innovative Learning, the dual diagnosis treatment for both adults and adolescents, and clinical trials.

"We have five different units for all different populations," said Ron Escarda, Fairfax CEO. "We have adult acute and mixed units, adolescent acute and general units and then a child unit." The units have anywhere between 12 and 34 beds; currently, there are 95 beds, though the facility is licensed for up to 133. The patients in the biggest units are assigned a team of psychiatrists, nurses, mental health specialists and social workers. In the smaller units, there is one umbrella of professionals that provides for everyone.

What kind of patients does Fairfax treat? "Basically, everyone who is in the middle of an acute psychiatric crisis," Escarda said. The hospital can accommodate any type of patient from bipolar disorder to depression to aggressive behavioral problems. "Our staff is talented to be of help to anyone," he said. Fairfax offers free assessments and referrals, 24/7 either by phone or in person. The hospital also has alumni patient support groups.

Dual diagnosis

Fairfax recently began a dual-diagnosis program for adults experiencing psychiatric crises along with drug/alcohol abuse. Both inpatient treatment and partial hospitalization are available, with groups meeting throughout the day to discuss a range of topics, from the origins of mental illness to symptom management to the development of coping skills. There is also the Northwest School of Innovative Learning for elementary and high school students who are unable to cope in a regular educational setting and need extra mental and emotional support. "We have graduated more than a dozen kids through our program that otherwise wouldn't have been able to graduate from high school," Escarda said.

The medical staff has positive reports: "It's one of the best hospitals I've ever worked at," said William W. Adams, M.D., M.B.A., the medical director of Fairfax. "I work with some great staff and it's fun to help the patients and get their lives reorganized." The psychiatrists are generally assigned to six to 10 patients, in addition to having their own private practices.

Escarda said unlike some other psychiatric facilities around the Seattle area (the psychiatric units at the University of Washington, Overlake Hospital and Swedish/Providence), Fairfax will take involuntarily committed adolescents and adult patients. "We're fully equipped to handle this," he said. Furthermore, Fairfax will accept patients who are on Medicare or Medicaid: "We do a lot of charity work," Adams said. "Probably a lot more charity than many of those other hospitals who are by definition 'charity.'"

Fairfax is working on clarifying its public image. "We need to improve what people think we do," Adams said. "People think we only treat children, but in fact we treat a wide range of adults." Adams went on to say how Fairfax is not only committed to helping the indigent, but also in helping the affluent: "We've always served people with lesser resources, but we also need for people to know that we want to make people who aren't poor also feel comfortable." Fairfax is in the process of renovation and expansion.

Both public and private psychiatric hospitals are badly needed. "Due to Washington state's grossly inadequate funding of the public mental health system, a crisis of inpatient mental health treatment capacity has existed for several years," stated the WSHA last January. The association also said that 150 beds at Western State Hospital and 30 beds at Eastern State Hospital were cut because of inadequate hospital payments, forcing community hospitals to close or downsize their mental health units.

This bed shortage is also affecting Washington's children, leaving Fairfax one of the only resources left for young people suffering from severe psychiatric disorders. The Public Consulting Group (PCG) documented in 2005 reported "significant strains on inpatient and residential services for youth with mental illness as well as inadequate community based alternatives." Funding issues threaten the closure of inpatient beds all around the state, including those in Children's Long Term Inpatient Placement Administration (CLIP): "Community-based care for children and adolescents... is very much needed," the group reported.

This mental health crisis, furthermore, is not only happening in Washington. According to the National Association of State Mental Health Program Directors Research Institute Inc., "Nearly half the states are reorganizing their state hospitals, including downsizing, reconfiguring, closing and/or consolidating." This means that there is now an acute psychiatric bed shortage across the nation - which increases waiting lists, overcrowds hospitals and creates backlogs in emergency rooms. "States are having to undertake a variety of activities and expenditures to address these problems," the Institute said.

Overall, Fairfax Hospital is an extremely valuable asset to the state. "Everyone there is dedicated to mental health patients," Sauer said. "They take patients who are voluntary and involuntary, they take a lot of low-income patients, and most of all, they are providing quality care."

Gwen Davis is a freshman in the honors program at the University of Washington and is planning on majoring in journalism.

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