Psychotic Reaction

Need emergency psychiatric care in Harris County? Have a seat. Or call a cab.

Small believes reducing the length of stays, moving patients into community settings and acquiring funding so that the time constraints on admissions could be relaxed a bit are more realistic approaches. Like the county's other mental health care providers, HCPC officials complain of not having enough funding. Since the center opened in 1987, its budget has been a flat $31 million per year.

Ben Taub, meanwhile, still must deal with patients dropped off by the police and city EMS ambulances. Bullard says closing Ben Taub's psychiatric unit on a weekend or holiday remains a possibility. Another, more unlikely option would be to divert emergency psychiatric patients to private hospitals. Bullard says he told the city's emergency ambulance service over the Labor Day weekend that "the treatment we could offer would not exceed the capabilities of any emergency room in the private sector," suggesting that the ambulances could take the patients to private hospitals. But since mentally ill patients who arrive escorted by police or in the back of a city ambulance are seldom lucrative prospects for private hospitals, few expect that to happen.

So Ben Taub adjusts. The deficiencies found by the state have been acted upon, with an emergency room holding area for pregnant women having been transformed into an a holding area for psychiatric patients on gurneys, and overflow patients now being placed in the holding area for non-psychiatric patients. Those two moves allow the "locked down" unit to be freed of excess patients, which Bayer says is an improvement, since "the more people who are in there, the more agitated they become." But mixing overflow psychiatric patients with patients in need of emergency medical care in the same holding area may just be a recipe for more problems.

Larry Newton, who has received treatment from all three of the county's main mental health care providers, questions whether the hastily implemented changes at Ben Taub will have more than a short-term effect. "It's understandable," he says, "but what are you going to do with all the people who go through Ben Taub if the main room can only hold eight people?"

Maybe just tell them to keep their seats.

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