Why we reported this story: There was regular reporting on COVID-19 outbreaks in jails, prisons, nursing homes and other group facilities during the pandemic. However, there was a gap in exploring how state psychiatric hospitals fared. Some facilities were reported on, but many others weren’t.
State-run psychiatric hospitals have dozens of people coming in and then leaving days, weeks or months later. Surprisingly, most of these facilities in the Mountain West reported having far fewer COVID outbreaks and deaths than other group facilities.
“As far as patients on unit, we didn't have any cases or anybody tested positive, until later on,” says Randy Rodriquez, administrator with Idaho’s State Hospital South, which has space for 110 adult patients.
COVID cases at that hospital affected a total of 45 patients since the pandemic began, but there weren’t any multi-patient outbreaks reported until August 2021.
And neither of the state’s two psychiatric facilities reported any COVID deaths as of late April.
“I feel like we've handled it really well,” Rodriquez says, adding that they have daily testing procedures.
These facilities are required to have infectious disease plans. Rodriquez also says that since many patients come via hospitals or jails, they’re screened for the virus beforehand.
Utah State Hospital also reported zero COVID-related deaths as of late April. It had an average of 277 daily patients from fall 2020 to this February.
That hospital did have some outbreaks, though, including 47 patients in late 2020 and 74 patients this year.
Dallas Earnshaw is superintendent there, and is on the Western Psychiatric State Hospital Association board. He says some are surprised how well these group facilities have done.
“Honestly, when this thing started, I thought, ‘Oh, dear, what is this going to be like when this spreads?’” he says.
“And just as it went on and I saw how staff pulled together and everybody took it seriously, I thought, ‘You know what? I think we got this.’”
Also as of late April, New Mexico reported zero patient deaths from COVID. Colorado reported one death after a patient left a facility and Nevada reported one staff death.
Some are surprised, if not skeptical, of the low reported case and death numbers.
“It is surprising, I will say. I mean, there's a fair amount of turnover in these facilities. People go in and come out,” says Curt Decker, head of the National Disability Rights Network.
Decker says many of the network’s state advocacy groups were just getting back inside psychiatric hospitals this spring. Many monitored facilities virtually for the last few years, which he says wasn’t ideal.
“We had situations where you could tell the staff person was sitting behind the individual on the call and trying to figure out how to elicit information when they're probably being somewhat monitored,” he says.
Decker says the Wyoming disability rights group is fighting for more access there. That state’s hospital reported three COVID-related deaths and 28 infections as of February, while having between 70 and 90 patients over that period.
Decker would also like to check how psychiatric hospitals across the U.S. recorded COVID death and infection numbers.
“It would be interesting to see whether the fact that they reported them or not and whether, if there were deaths, were they attributed to COVID,” he says.
Some states have murkier data than others.
Arizona health officials refused to release data on how many people at their state facility died from COVID, or were infected. Some are fighting for more oversight of the psychiatric hospital there, since state officials are in charge of both the hospital’s regulation and oversight.
And then, there’s Montana.
“We have a facility that is understaffed, underpaid, undertrained and under appreciated,” Disability Rights Montana Director Bernadette Franks-Ongoy said in a legislative hearing in March.
Montana’s one state hospital – where three COVID deaths were reported – recently lost federal funding. That followed staff complaints about leadership, a failure to implement plans and extremely low staffing levels, which created an unsafe environment.
Short staffing is affecting all other facilities, too, regardless how well they’ve handled the pandemic.
Laura Hill, head of nursing at State Hospital South in Idaho, notes one factor – their facility didn’t have nursing students during the pandemic.
“And that's kind of how people come here and they experience our hospital and then they want to work here. And so we hire a lot from our nursing programs, so we kind of lost that opportunity,” Hill says.
The nation's housing crisis is also challenging – for staff and patients. To control further outbreaks, hospitals need enough staff, and those staff need housing.
Patients also need safe places to live before they can be discharged. If that’s delayed, it can cause other issues.
“Being able to have a safe and appropriate setting for patients to discharge to is an ongoing issue,” says Kevin Young, social services director with the Idaho hospital.
Meanwhile, workers simply have to keep being creative, fighting burnout, dealing with COVID cases, and trying to work with people who are often experiencing the most challenging time of their lives.
This story was produced by the Mountain West News Bureau, a collaboration between Wyoming Public Media, Boise State Public Radio in Idaho, KUNR in Nevada, the O'Connor Center for the Rocky Mountain West in Montana, KUNC in Colorado, KUNM in New Mexico, with support from affiliate stations across the region. Funding for the Mountain West News Bureau is provided in part by the Corporation for Public Broadcasting.
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