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Report: Tulsa facing critical lack of youth psychiatric beds

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Adding more youth mental health beds in central Oklahoma would be an asset to the state overall at a critical time, but it won’t help Tulsa gain ground in an area in which it’s sorely lacking.

According to a new report released this week, the Oklahoma City metro area is home to a disproportionate concentration of the state’s already limited number of psychiatric beds for youths.

The report comes at an eventful time, as officials are considering the use of federal COVID-19 relief money to increase youth bed capacity, including by adding more than 70 new beds at a planned OU Health facility in Oklahoma City.

“It’s wonderful to have the beds there because it’ll keep more children from going out of state,” said Zack Stoycoff, executive director of the Healthy Minds Policy Initiative. “But in terms of placing beds near the need, there’s certainly something to be said — if we have resources for inpatient services — for Tulsa and also rural areas being part of that conversation.”

The report, available in full online, is the latest in a series from Healthy Minds on the state’s mental health care system for children.

A Tulsa-based mental health advocacy group, Healthy Minds is part of a coalition of area health care leaders who team up to find solutions.

The report notes that of around 915 youth mental health beds statewide, about 60%, or 556, are located in the Oklahoma City area.

At the same time, the area is home to only 36% of the state’s youth population, age 6-17.

Tulsa County, meanwhile, has 26% of the youths but only 12%, or around 115, of the beds.

Nonmetro areas have 27% of the beds and 37% of the youths.

Moreover, Tulsa has actually lost 116 youth beds since 2018. That’s about half its former capacity, with most of the losses coming from the closure of Shadow Mountain Hospital.

Bottlenecks in the mental health system created by the bed shortage have only been made worse by the COVID-19 pandemic, Stoycoff said.

“We’re seeing record numbers of children going to hospital emergency rooms in Tulsa where they are, frankly, warehoused, often for days or longer, as a bed is sought,” he said. “Children are really just sitting there and not receiving appropriate care.”

Of the 947 youths from Tulsa County who were placed in an inpatient, residential or crisis residential facility in fiscal year 2021, 27% were placed in a facility outside Tulsa, according to a Healthy Minds review of Medicaid claims data.

Stoycoff said: “Anecdotally, we hear from providers outside of the Tulsa area that they see quite a few Tulsa clients. When you put the data to that, you start to realize there are a number of Tulsa clients who are going across the state or even out of state, meaning families are driving many miles to receive appropriate care.”

One big reason for the geographical disparity in youth beds, Healthy Minds reports, is that 222 of Oklahoma City’s are operated by private general acute care hospital systems.

Tulsa lacks inpatient psychiatric beds in its general acute care hospitals, which is unusual for a city its size.

“Tulsa, we found, is really rather unique in the country in that,” Stoycoff said.

The OU Health mental health facility targeted for Oklahoma City is the most significant current proposal to expand bed capacity for children in Oklahoma.

It is to be a $115.8 million facility that would add 72 children’s inpatient beds, and project leaders have requested that a portion of it be funded by the state’s share of American Rescue Plan Act funding.

If the OU project is completed and the rest of the state’s beds remain at their current level, the Oklahoma City area would house 68% of the state’s youth inpatient beds.

The Healthy Minds report found that while the new beds would provide immediate relief, they won’t meet the need on their own.

Making the problem worse, the report notes, is the fact that Oklahoma already has an over-reliance on inpatient and residential beds due to the absence of home- and community-based care.

But while that larger issue needs to be addressed, more beds in the places that need them most, like Tulsa, would be a big help.

In addition to adding beds, Stoycoff said, another more immediate solution to “stem the tide at the emergency room” would be creation of a “front door triage center” for mental health.

“We have that in Tulsa for adults — a crisis care center operated by Family & Children’s Services. But we don’t have that for children,” he said.

Stoycoff said an ARPA request is pending with the city and county to renovate a facility that has already been funded operationally to provide those services.

To read the full report and the previous ones in Healthy Minds’ children’s mental health series, go to healthymindspolicy.org/children.


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