When Aspen Springs Psychiatric Hospital opened in Hermiston last fall, it was hailed as a sorely-needed addition to the state’s meager supply of mental health treatment beds.
But the facility closed on April 8, after less than seven months in operation, highlighting another problem with rural mental health care — a shortage of qualified staff.
Lifeways, a community mental health provider covering parts of Eastern Oregon and Idaho, opened the 16-bed inpatient hospital for acute psychiatric care in September 2020, four years after it first broke ground on the project. It served a total of 75 patients between its opening and its closure on April 8.
The facility provided the highest level of psychiatric care offered in Oregon, for individuals experiencing a severe mental health crisis.
When Aspen Springs closed as a psychiatric hospital, the Lifeways board of directors put out a statement that they had made the decision because “the realities of COVID-19 and the health care worker shortage, especially for rural psychiatric hospital level licensure and credentialing, creates an unsustainable situation.”
Lifeways quickly reopened the building as a secure residential treatment facility, which still provided inpatient mental health care but came with lower staffing requirements.
COO Liz Johnsen said that the biggest problem in operating as a hospital was finding psychiatrists, which under Oregon rules for acute psychiatric care hospitals must staff the facility 24 hours a day.
She said Lifeways had received a waiver from the state allowing psychiatrists to provide care via telemedicine for the first 12 months. But after Aspen Springs passed six months of operation, plus months of recruitment efforts before that, with no luck finding even a single full-time psychiatrist willing to come to Hermiston, Johnsen said it became increasingly clear it would not be able to meet requirements when the waiver was up.
“And so as we looked forward, and knew that waiver wouldn’t be granted, and really looked at the care that we were bound to provide, it was just untenable,” she said.
On top of that, Johnsen said, it was also difficult to find enough nurses willing to work in both a psychiatric facility and in a rural setting, particularly during the pandemic.
She said Lifeways leadership had known it would be difficult to staff the hospital because of those challenges. But they had expected to be able to find enough people in time.
“It’s always been a risk point for us, but we didn’t think it would get to this level,” she said.
Hermiston has about 18,500 residents, but the shortage of mental health staff isn’t unique to towns of its size. Oregon State Hospital in Salem recently brought in 30 National Guard members to staff its facility after staffing reached crisis levels.
Umatilla County leaders have often lobbied the Oregon Legislature for additional funding to support capital projects, such as a planned expansion of the Umatilla County Jail that would help staff better accommodate people coming in while experiencing a mental health crisis or needing to detox.
But Umatilla County Commissioner John Shafer said they also need to look at solutions to address the shortage of licensed mental health professionals, particularly those willing to work in a rural area. He said some sort of financial incentive for providers to work in small communities could be a start.
“It’s definitely a pressing need out here,” he said. “Infrastructure is one thing, but without professionals to run the building, it’s going to be an empty building.”