San Antonio (Texas) State Hospital put a temporary hold on admitting adult patients on Thursday due to a nurse shortage, according to San Antonio Express News. Adolescents will be admitted on a case-by-case basis.
The 302-bed hospital serves poor, uninsured psychiatric patients who are potentially dangerous to themselves or others. SASH is one of just 10 mental health facilities within the Texas Department of State Health Services. It serves more than 50 counties in the San Antonio area, according to the report.
"We have a total of 83 nurse positions at the hospital, and 12 of those are vacant, plus we have several nurses out for an extended period of time due to medical reasons," Carrie Williams, a spokeswoman for the Texas Department of State Health Services, told San Antonio Express News. “We've had several nurses recently leave for other positions in the community."
Some of the 40-bed units are staffed by as few as one nurse each and not all shifts are staffed, according to SASH Superintendent Bob Arizpe.
Mental health advocates believe the situation could put a great deal of stress on local emergency rooms, since SASH may not be able to admit any new patients until February. Local hospitals have psychiatric beds, but they are reserved for patients with insurance, according to the report. Judge Oscar Kazan, who presides over the Bexar County mental health court, told San Antonio Express News that three hospitals have already felt the effects, having nowhere to send patients. Some patients are being sent to hospitals in the Rio Grande Valley, he said.
Results of a lawsuit two years ago put additional stress on the capacity of the hospital, according to the report. The hospital has a number of beds set aside for forensic patients, or mentally ill jail inmates in need of treatment. After the suit, the hospital needed to expand the number of forensic beds. However, it expanded by taking beds from the civil side of the hospital, according to the report.
"We've been underfunded in behavioral services in Texas so long, and we don't think outside the box," Leon Evans, CEO of the Center for Health Care Services told San Antonio Express News. "Our funding is in silos, and we've got people taking up beds at the state hospital that don't belong there, people with Alzheimer's and closed-head injuries, taking up civil beds. And we have no community-based alternatives, no step-down units, no residential treatment facilities."
Texas Department of State Health Services is pulling nurses from other areas and considering using temporary nurses to address the shortage, according to the report.
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