IN RECENT YEARS, HCA has been successfully growing its behavioral services at facilities near military installations in order to address the needs of military personnel returning from active duty. In recognition of the increasing demand, even more services are being added across the entire company.

“Behavioral Health providers have been scrambling to add services in their communities, whether that’s for service personnel or other groups,” says Terry Bridges, President of Behavioral Health Services for HCA. “We have been working with the military as they try to do a better job of identifying soldiers at risk, and help them with treatment support. That has helped us develop programs such as the ones at TriStar Skyline Medical Center in Nashville, as well as at facilities in Kansas City, Jacksonville, Fla., and coming soon to Gulfport, Miss. We continue to work with the bases in Pensacola, San Antonio, Corpus Christi and elsewhere to address those needs.”

At the same time, there are 14 facilities either expanding their psychiatric services, or adding new ones. Add to that another nine on the drawing board, and HCA overall has a very active development focus for Behavioral Health. While some of these will care for our active military personnel and veterans, most will devote their time and attention to geriatric care, a growing concern in many communities where senior-citizen populations are exploding and services are scarce.

“We are evaluating each of our communities for behavioral health service needs,” Bridges says. “In some cases that may mean adding adolescent care as well as adult, both inpatient and outpatient services.”

Growth presents challenges

In fact, outpatient services are expanding, even though that aspect of mental-health care coverage is a challenge given the national shortage of psychiatrists to provide traditional outpatient therapy.

“Many of our units are constantly full, so we know that the services we offer are of high value to the community,” Bridges explains. We want to make sure that we have ample capability to serve those patients as they arrive to our hospitals and emergency departments, so we can ensure they receive the appropriate level of care right away.”

In addition to the physical renovations and expansions, focus at many hospitals also is on community outreach, so area residents can be made aware of psychiatric services. That’s key, because often those can be provided in tandem with other treatments, especially for the senior population.

“We are working with local care providers such as nursing homes and other residential facilities, as mental illness is very common with seniors as they deal with stresses of aging and illness,” Bridges says. “Forecasts show that behavioral health services for both inpatient and outpatient is expected to be one the most in-demand healthcare needs over the next decade.”

New facilities vital

Some of that can be tracked through recent healthcare reform issues, which are predicted to bring as many as 60 million covered lives into the healthcare system over that time period. But even more pressing is a national shortage of psychiatric-care beds.

“In the 1950s, there were around 550,000 psych beds; now we are down to about 40,000 across the country,” Bridges says. “Systems to meet the existing need are lagging, and with a lot more patients coming, who will have coverage, we need to be ready. That’s the case with every provider, but most of them are responding with freestanding facilities. That means they don’t have the medical facilities that HCA can offer, and so they can’t offer comprehensive care to meet the needs of most behavioral patients as nearly two thirds of them suffer medical co-morbidities.”

For example, he describes a senior citizen who suffers from mental issues, but also has a host of other conditions, including cardiac problems. He or she would not be treated for both issues in a psych-only facility, but at an HCA hospital all medical needs could be met.

“That’s the advantage we have,” Bridges says. “As reform rolls forward the integration of physical health with mental health becomes even more critical, which many have not done because reimbursement issues made it difficult to combine the two. But if you look at patients in the emergency department with behavioral issues, or post-heart attack patients who are depressed, you can see the need. It is important to treat the comprehensive needs of the patient and at HCA, we are striving to do just that.”