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The Many Doors of Healing: Mental Health Care at Centra
Mental health needs have consistently topped community health assessments in our health system's area for years, reaching critical levels that demand immediate attention. Ismael Gama, Vice President of Centra's Psychiatry and Behavioral Health Service Line, shares how Centra is responding with a strategy that creates multiple pathways to care.
The cornerstone of Centra's approach is meeting patients wherever they enter the system. "Come to whatever door and we will get you to the right place," explains Gama, highlighting how this philosophy removes barriers for those in crisis. From the Psychiatric Adult Urgent Care seeing 20-25 patients weekly to the groundbreaking EMPATH unit that has treated 1,500 patients in two years with an impressive 85% being discharged home rather than admitted, these innovative models are transforming mental health delivery.
Whether you're seeking care for yourself or a loved one, this episode provides information about accessing mental health services throughout the region, including addiction treatment options, telehealth availability and how to navigate the system through primary care or urgent care.
Learn more at Centrahealth.com/mentalhealth
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Hi and welcome to, and so Much More.
Speaker 1:I am your host, cammie Smith, and I am here with Ismael Gama, who is our Vice President of the Psychiatry and Behavioral Health Service Line at Centra, and so when we say service line at Centra, we mean it's like the department that encompasses all of our mental health related care and services, and so obviously this is a huge need in our community right now, addressing the mental health in positive and in the ways where people are, you know, excelling, and also, but in the ways where people are struggling and they really need help.
Speaker 1:It's a huge conversation and so there's so much that's happening, things that we're kind of putting legs under and setting up and to bring that into the light and help share with you all what is happening now that there has been a clearly identified need for years, consistently, years, consistently, our community health needs assessment has shown us that the mental health needs in our various communities that we serve it is critical, the level is critical. So we have been working and are continuing to work to get a lot of services and facilities and caregivers in place to meet that need. Some things have come to fruition, like MPATH and the PPAUC Psychiatric Adult Urgent Care Center. But there's more coming and you have all of the knowledge. You have all of the pieces.
Speaker 2:I'm not sure about that, but yes, some of the knowledge you can help put some of these puzzle pieces together so that I mean, I'm sure community has questions.
Speaker 1:Some of them you can help put some. Put some of these puzzle pieces together, um, so that I mean I'm sure community has questions. They see new construction, they hear about our new facility with life point. They, um, they hear about our modernization plan and and kind of how that has evolved over the past few years. They've seen the parking lots come into place and you know, like if you build the parking they will come, and so we're getting the bones and the foundation in place to support all of the work that we're doing.
Speaker 1:So first let's talk about the need. So our community health needs assessment, which is a needs assessment that is taken by you, our community, that helps us identify which areas need the most care Over and over and over in the three areas where we do put out this survey and those areas encompass large areas but Lynchburg, bedford and Farmville essentiallyford and Farmville essentially, and that covers the Danville and the Gretna and the Amherst and the places that kind of fall within that Mental health needs is over and over and over again coming to the top, rising to the top. So what does that look like?
Speaker 2:Yeah, so you're giving a good foundation here. We have a tri-annual community needs assessment that we in the last couple ones has always been around. Mental health yeah, top priorities, right illness diagnosis so almost 23% you can look at the emergency rooms these days, children more and more looking for mental health support. There's an impact, not only post COVID but it's still growing, on media bullying. So all those pressures of society, media channels, have been contributing to this need of mental health and addiction services. Right, it has been a very surprising number of young adults and really teenagers having issues with mental addiction services.
Speaker 2:So as we look at the context within Virginia and really if we look at the, the adult, almost 23% have mental illness or are diagnosed. It follows the the national trend and so it's it's astonishing to see that number continues to grow. So related to us, we are trying to provide more and more care and abilities for folks to receive care. We have one purpose, as we say in many doors, different ways that people can receive that care. And you did mention our urgent care, adult urgent care that we're seeing an average about 20 to 25 folks per week coming to our urgent care and that helps not to folks going to the ED, which is not really appropriate place for behavioral health patients in crisis, and alleviates a little bit of that pressure. So, going to the urgent care, they really receive that immediate care and it helps.
Speaker 1:So I want to talk about this urgent care a little bit, because I know that urgent care people just define urgent care in different ways. So when you are looking at psychiatric adult urgent care, psychiatric adult urgent care what specific things should people go to the psychiatric urgent care for, versus our regular clinical urgent care, versus the ED? So let's filter out regular urgent care and the ED. What should they be coming to the psychiatric adult urgent care for?
Speaker 2:Great question. So some of the signs of distress right, someone is really depressed, perhaps the first time that family or friends see this person very depressed all the time. So in a moment like that, urgent care fits very well in continual care. Right, it's not really an emergency, but someone to be evaluated. One of the increases in this town, in Lynchburg, that we have colleges and universities. The first year of college and university is when young adults begin to go through their first crisis away from home and now perhaps they're not feeling well, very depressed. So urgent care fits that profile. Obviously the urgent care as they assess the patients, they can also assess to see. Well, I think this is a little bit more acute. So we can transfer them to the emergency room, also to the empath unit that you just mentioned, right? So appropriate ways for us to care for the community, away from the business of an AED department.
Speaker 1:So something that I really respect about the psychiatric behavioral health services. I say department, but you all have created to your point these doors, but you all have created to your point these doors. And I think that so many people don't just come for help because they don't know which door to go to. But I think what is very important to know and I think is so wise come to whatever door and we will get you to the right place. And that's not just Lynchburg or Bedford, like you. Go to whatever door in your community and we will get you to the right facility in the right location that has the correct care for you in that moment and that can take out of the equation the oh my gosh, I don't know where to go and I'm having a crisis. We are trying so hard to help you, our community, identify where to go for what type of care, but so many people in that moment when you're in crisis, I mean there are so many things flying through your head and so, like Centra, is this enormous network that will get you to the care that you need, and so I love that you talk about all the
Speaker 1:doors and there are appropriate places to go for certain types of care, but fully understanding that if you're having a crisis and you come to the psychiatric adult urgent care and it is something where you really need to be in the empath, we're going to get you to the empath and so you're going to get the care you need, you're going to get taken care of. So the and we call it P-P-A-U-C just because it's so much easier to be like adult psychiatric urgent care, and so I think that just getting that out there, it's almost like I want to repeat it over and over and over so that it pops in your head in that moment. So we have the urgent care set aside, we have empath. How is empath going?
Speaker 2:We're at what two years yes, about two years now we saw about the volume right now we saw almost 1,500 patients going through the empath, 1500 patients going through the empath. So, as you can imagine, it has been. The community has embraced that in such a way that it reflects the care we provide the specialized place for people going through mental crisis, mental health crisis and it's right away. You receive care immediately, as soon as you come in. So it is doing very well. One of the things we noticed that 85% of the patients that come through the empath unit they end up being discharged home. So it's very interesting because as soon as you get a care, your whole crisis diminishes a little bit. Yeah Right, you feel at ease. We spend a few hours with us observation average about 24 to 48 hours, and then they are discharged home.
Speaker 1:As opposed to being admitted Exactly. That's amazing.
Speaker 2:Because before you go to the emergency room, easy way out to be pushing folks away is to send to an inpatient unit, right. So now we have 80, 85% going home, those who cannot go home. We find a bed in an inpatient unit or, even better, outpatient services. We have what we call bridge clinic that patients can. Waiting for an appointment these days is difficult at times. We try to expedite as much as we can appointments with our psychiatrist, but they have a bridge clinic, so the provider will call you as a patient saying, hey, this is your prescription. Are you taking your prescription? And keep checking on them until they have that first appointment.
Speaker 1:That follow-up to kind of keep people from falling through the cracks.
Speaker 2:That's right.
Speaker 1:That's incredible. So when did this bridge clinic start?
Speaker 2:In the very beginning, as soon as we, a couple months into empath unit one of our providers, Drew White was able to establish a bridge clinic. That is incredible, and Drew's right there in the emergency department.
Speaker 1:So that's a very, very cool story of somebody identifying a need and then the bones kind of put it around, fixing that and meeting that need. So in what other ways, like what? In what other ways are we meeting this mental health need? So here those are some of the established services. So what's coming?
Speaker 2:So we're very excited now that we're looking into so we mentioned adult urgent care. So what we're looking into so we mentioned adult urgent care yes, so what we're looking now is child adolescent urgent care. So those kids that show up in ED and many of them have autism diagnosed, so it's very difficult to manage them on a highly of highly, a lot of stress around them, right, yes, noises and things like that. So we are now launching into a program that we'll call Child and Adolescent Urgent Care. It will be established at the Autism and Bridges Residential.
Speaker 1:It's already there, the campus Over there on Leesville. Yes, that's right.
Speaker 2:Close to the new hospital. We'll talk a little bit about that. But yeah, so the child and adolescent urgent care will be another door, another way where parents can bring their children to a specialized right away we can care for them and really moving them away from that stressful environment which is the ED. So the same way we're doing with the adults if kids are in distress and crisis and they need an inpatient acute bed, we'll provide that. But in that campus we'll have IOP we call intensive outpatient programs, so it fits into the category right, you don't need an acute bed, you don't need to spend time in the hospital, but you need more attention throughout the week. So we'll have a day program also craft around the child crisis that they are going through.
Speaker 1:Yes, and how strategic, because that is where those providers are. Where those providers are, that is where the specialist for the children who are within the age group that is going to be. When can we expect that? I'm really excited about that, that's exciting.
Speaker 2:Right now we're going through establishing a couple of things in that campus, right. So we're bringing our providers from Piedmont Psychiatric Center for child care providers, so they will be relocated. So they'll all be coming, will be relocated in the same campus. We have already the autism clinic there. We have the residential, as I mentioned, bridges, and we're now looking into third quarter, fourth quarter this year to establish that it's coming pretty quick, yes, and for the delight of our community in some ways. Yes, and together with that, we're developing right now we call autism residential beds. So, as I mentioned, we have residential for children as young as six to 17 and a half and we'll have a track specialized for kids with autism and residential needs.
Speaker 1:So we already care for these kids on and off.
Speaker 2:They come into our residential program and they end up being diagnosed with autism, so they're developing a special program for that.
Speaker 1:Okay. So and that will also be on that same campus, same campus.
Speaker 2:We're looking at the possibility of renaming the campus. Some people know that campus by Bridges others for Autism Clinic. So right now, for the sake of having a name, we're talking about Chattanooga-Lesson Campus, but we're open to Easily identifiable.
Speaker 1:Yes, that's right, yeah, so that our community like it's so important for you all to know what is where and and you know how to find that, that that uh service that you need in that moment, especially for an urgent moment of crisis. So we've kind of we keep mentioning LifePoint.
Speaker 1:We keep mentioning the new mental health hospital. Um, we've talked about it a lot as a health system, I want to say, over the past year. Um, since you know, the news first came out and we have a groundbreaking and so what, what, where are we now? And maybe do a little recap of what this is going to be for those who are hearing about this for the first time, sure, where are we now?
Speaker 2:So this is a joint venture. Centra was looking for a partner that has a lot of experience in managing behavioral health hospitals and also rehab. So it's a joint venture that we're building right now, as we speak, two brand new hospitals One is the rehabilitation hospital, the other one is behavioral health hospital with LifePoint. So the joint venture is really. Centra is the major partner and we are very excited about that because, as you can imagine, some of you know this already Virginia Baptist, where we have our three acute units adult geropsych and child and adolescent. We're not built for psychiatric care. Parasyc and Chardon-Lassen were not built for psychiatric care right Patients in those units, they don't have the ability to go outside.
Speaker 2:I remember a story a couple of years ago, when I first came here. One of the patients, a young kid about 12, 13 years old, told our providers you know, I keep running in front of the window pretending that I'm outside, right.
Speaker 1:So, that's so it's not good care, right it's tough for them.
Speaker 2:So now, with the new hospital state of the art design, patients will have the ability to go outside.
Speaker 1:And how healing.
Speaker 2:I mean, the environment is just so healing. It's completely part of your way of you getting well Right.
Speaker 2:You need the sunshine, fresh air, so we are very excited about that right, comparing to a building over 100 years old now to a state-of-the-art facility, more efficient. As some of you probably know, our units are all in different parts of Virginia Baptist. They are not in the same part of the building. So with the new hospital we have right now we have 60 licensed beds at Virginia Baptist and we'll increase to 72 beds. So we're very excited about that 24 beds, three units for adults, geropsych and child and adolescent. So that will bring efficiency. We have new technology to keep our patients safe, our employees safe, and with that, all in the same floor really right, same level so that brings a lot of employees and caregivers into the same area to deliver care caregivers into the same area to deliver care.
Speaker 1:Yes, and one thing I think it's important to mention in light of just information that's floating around in our community right now, is that it's the yes, the care is going to be different, it is going to be a different approach, but that is because of what is being made available in this new facility. And so I think right now, you look at what is being offered without the context of how different of a space and how different even that space allots time that's available, like it just changes everything when you have the proper tools at your disposal in a new way. And so, of course, whenever there is change, there's just that rub of um, of just uncomfortable, and you know people, they don't know what to expect, um, and and also, you know it's hard to picture something that could look very different than what you're used to right now. But even hearing about that boy and being, I mean, I think of my son, who's 13 years old, and if he he just he needs to be outside sometimes, and just that independence of being able to go and ride his bike and he's on the spectrum he has autism and that is a huge part of I call it healing, but that's a huge part of just his regulation on a daily basis is being able to engage with the outdoors and just like feeling the sun on your face and
Speaker 1:and so I don't know. I think that having an open mind to something that we can't see yet and we can't really imagine, and and really looking at how you all, who have been living this for the past, however many years, are stepping into providing better care because of more available to you, and so I think that would be an important message to just mention for those who are watching, who are hearing a lot of this information that's floating out there is when you're stepping into a new facility that opens doors that are going to be life-changing for our patients, just being open-minded to what that could look like.
Speaker 2:That's right. Even today, as I was describing, we have a unit that is on first floor and then you have child and adolescent sixth floor. So whenever you need a partner or another nurse or a therapist, it's a traveling distance and response and delay.
Speaker 2:So in the brand new hospital, all in the same, like I mentioned, all the units parallel to each other, outside, for each one of those units they have their own outside space, great, great facility. So all that is part of the efficiency that we will have. Plus Centra is the major partner in this joint venture and we have a board that will make sure that we have keep our quality, keep our care the way it is compassionate care, great quality of care that we provide to this community. So the board will be working with LifePoint to make sure that we have those elements of quality and safety that we want to continue offering to this community.
Speaker 1:Yeah, that's incredible. Well, as a parent who you know is doing life shoulder to shoulder with other parents with children with disabilities, that is so it's so good to hear. It gives that peace to and for me it's my child. But for those of you who are listening, who are caregivers, like maybe it's a parent, maybe it's a spouse or a family, my brother, sister that peace of mind to know that that is coming is very exciting. So is there anything else we haven't covered that you wanted to address or talk about or share about how Centra is, kind of well, is meeting the needs, this identified need of mental health in our community?
Speaker 2:Sure, I mentioned briefly about addiction services and so I want to make sure that the community knows this. Towards the end of last year, we opened a clinic Addiction Treatment Center in Farmville. It's one day a week right now. The volume is increasing, so we're looking at areas where we can continue providing that extra door, a way for you to not have to travel all the way to Lynchburg but right there in your community. So we opened the addiction clinic. Also, we're looking into IOP for those who have difficulty of traveling, so providing a way for them to continue receiving care.
Speaker 2:And we have the residential addiction. So we have the clinic on a crisis basis, patients with addiction issues or difficulties can go to the clinic. But we also have the residential, which we have about 20 beds and really it's continued to provide that care. One of the things that we're looking at is really the community needs assessment. Your community is telling us what we need to address and as part of that and we mentioned a couple of times our addiction it's continued to grow addiction needs and we're looking into ways to how can we address adolescents having those challenges as well.
Speaker 1:So if we can offer a day program, this is what we're looking at right now a child and adolescent campus, but also a IOP intensive outpatient programs, as well, yes, and I want to encourage you all to go, as you're hearing intensive outpatient programs and adult psychiatric urgent care, and we're talking about the children, the adolescent urgent care that's coming.
Speaker 1:Go to the website, and we have organized this psychiatry and behavioral services pages in a way for you to search for the services that are available to you, broken down by inpatient, outpatient, addiction and recovery, neuro, neurodevelopmental services, and so so that you can see exactly what services are available for the needs that you have in that moment.
Speaker 1:So, if you head to our homepage and you can click on psychiatry and behavioral health, and that will take you exactly where you need it will take you to our location pages with phone numbers where you can click on psychiatry and behavioral health, and that will take you exactly where you need. It will take you to our location pages with phone numbers where you can call and speak with a nurse, connect with some of the providers. We just launched some of our new provider profiles, which is going to tell you which of these providers are going to treat which services that you need, and so I really do encourage you to familiarize yourself with it, because this is what is available. We're literally here for you and so go and see how we can meet that need, because a lot of these areas currently do have access, and when we say access we just mean they can take patients now.
Speaker 1:You can come and get care now, and we want that for our community.
Speaker 2:And we do have telepsych right so if, for any reason, you cannot reach a provider, we do have the ability to do a Zoom call, facetime, whatever you have for us to provide that care urgent care and primary care offices offices. They know that if you show up to your provider primary care and you're in a mental health crisis, they will be able to to provide that connection so you can receive care.
Speaker 1:How can they get connected to that through their primary care?
Speaker 2:through their primary care, yes, and and primary care, yes, and they help facilitate those calls. If you don't have a primary care provider these days, show up to our urgent care right. So urgent care is the best way for you to receive immediate care, and then would navigate based on your needs where you're supposed to go, go and a provider will be available to you as well.
Speaker 1:And that's over at Virginia Baptist Hospital. You go up to the front where you'll see the pathway sign, and it's just around the corner from pathways, so head there and get set up with whatever it is that you need. Yeah Well, thank you so much. We covered so much information.
Speaker 2:I hope everybody's taking notes.
Speaker 1:I appreciate your time.
Speaker 2:Sure.
Speaker 1:And thank you all for joining us on.
