By Dennis R. Dubey
For the third time, the state Office of Mental Health (OMH) intends to move Western New York Children’s Psychiatric Center (WNYCPC) to Buffalo Psychiatric Center. This is a return to the old days, when the first psychiatric ward for children opened at Bellevue Hospital in New York City during the 1920s. Forward thinking in the late 1960s led to the opening of six psychiatric hospitals exclusively for children.
In 2001, the State Assembly rejected the governor’s proposal to relocate children’s psychiatric centers to the grounds of adult centers. The Assembly insisted that “there will be no interchange of staff between a children’s facility and an adult facility and that all children’s services will be delivered by staff who are specialists in children’s mental health.”
The arguments against consolidation of adult and children’s centers have been presented in many news stories and op-eds. OMH assures us that there will be no harm. One thing is certain. Over time, the care and treatment provided to these psychiatrically ill youth will deteriorate.
Currently, the executive director of WNYCPC can hire anybody she chooses in accordance with Civil Service rules. For some positions (e.g., psychiatrists, psychologists, social workers and several supervisory titles) the director can hire professional staff with specific credentials to treat children and youth. But these special children and youth titles are not required, and children can be treated in OMH hospitals by staff without such credentials.
Once WNYCPC is merged with Buffalo Psychiatric, everything changes. As staff positions open on the children’s units, other staff members with no children’s experience are free to take those positions. Buffalo Psychiatric employees with seniority can request and take openings on the children’s unit.
Child psychiatrists are hard to find. To cover a vacancy, a psychiatrist with no children’s experience can be assigned to cover a children’s unit. The same can happen with psychiatric nurses, psychologists, social workers, therapy aides and recreation workers. Some vacancies are never filled, and existing staff takes on greater patient caseloads.
The Children’s Psychiatric Center benefits from a full-time executive director to provide leadership, dedicating full attention to children and their families. That leadership has been key to the successes at WNYCPC and other OMH children’s facilities. Once that executive director splits those leadership responsibilities between two overwhelmingly complex adult and children’s inpatient and community systems, that leadership is compromised.
Executive directors at our children’s hospitals have immersed themselves in the clinical care, support services and community programs. This immersion has led those facilities to provide effective treatment, safe care, low readmission rates and high grades from accreditation organizations. If you want to keep all of that, keep WNYCPC right where it is.
Dennis R. Dubey, Ph.D., was executive director of Sagamore Children’s Psychiatric Center on Long Island from 2003 to 2011.