A year ago, we celebrated state officials’ partnership with UT Southwestern Medical Center to allow the academic institution to operate Dallas General Psychiatric Hospital. We welcomed the news of 200 new beds for people with severe mental health struggles, realizing that it was a major investment by Texans, even if it was just nibbling at a problem too big for a single hospital to solve.
Today, we encourage Children’s Health to grow this investment. This week, the private healthcare system signed an agreement with state officials to donate about 100 pediatric beds to a planned Dallas hospital. The family will be run by UTSW.
“This is a big deal,” said Scott Schalchlin, the executive deputy commissioner of Health and Human Services in Austin who oversees the state’s network of public psychiatric hospitals. “I can’t stress enough the need there.”
Schalchlin’s comments at a legislative hearing in June, which revealed that the donation was in the works, drew an uproar from state lawmakers. Officials remained largely silent about the donation over the summer as they prepared the legal aspects of the agreement. And only now, after signing the deal, were they willing to open up about this development in child mental health care in North Texas.
Families of Texas children with severe mental health challenges are in dire need of such a family presence, along with a range of care options that might deter them from seeking a hospital stay in the first place.
Lindsey Tyra, executive vice president and director of strategy for Children’s Health, said hospital leaders have committed $200 million to pediatric psychiatric beds. The Children’s Health Center does not have a dedicated inpatient psychiatric unit, but it does have partnerships with two private psychiatric hospitals and works with other community organizations to provide early mental health interventions.
“Children’s Health routinely invests in children’s programs and facilities necessary to provide care to our patients,” Tyra told us. “Noting this increased need for pediatric mental health care, we foresaw the need for a significant capital investment in patients’ beds.”
Our hearts sank when the Centers for Disease Control and Prevention sank mentioned Child mental health visits to the emergency room in 2020 increased by at least 24% compared to the previous year. According to the post newsletter ReportsChildren across the country are “boarding” into emergency departments while they wait for a psychiatric bed to open somewhere.
This is true even in North Texas, where there are more than a dozen private psychiatric hospitals, most of which accept some children. It’s common for families to wait days or even weeks for a psychiatric bed, said Dr. Hisham Ibrahim, associate vice president and professor of psychiatry at UTSW’s Peter O’Donnell Jr. Brain Institute.
These are families whose children commit suicide, suffer psychosis, or behave in dangerous ways.
“Inpatient pediatric psychiatric units are not intended for continuing care,” said Ibrahim, who is also the chief medical officer for Ambulatory Services at UTSW. “They are really there to address critical needs when a child’s mental health condition becomes so severe that it requires urgent and intense interventions to ensure the child’s safety.”
The new state hospital in Dallas will receive patients from across the region. The proposed site is located at the corner of Harry Hines Boulevard and Medical District Drive in the city’s medical district. Officials say the adult beds will open in the fall of 2025.
“We want this hospital to be first and foremost a resource for the community and treat underprivileged patients,” Ibrahim said.
But the trip to this hospital is not supposed to be a long stay. Ibrahim said it was important for the children to go home as soon as possible, and the hospital would put in place individualized treatment plans that would make that happen.
Many details about the pediatric unit have yet to be determined, such as its location relative to the adult facility, the age group that will be provided, the services provided or how patients will be able to get to bed. In Texas, the point of entry for low-income patients is usually the local mental health authority, which directs people to available beds.
However, hospital design guidelines are beginning to come into focus. Ibrahim said officials rely on community feedback as well as best practices from state-of-the-art, award-winning mental health hospitals across the country. For example, Dallas-area residents said it’s important for patients to have private rooms and bathrooms.
Nor should patients feel trapped, which is why state and UTSW officials envision parks and plazas for access to sunlight and fresh air.
Every healthcare leader who spoke to us about this hospital is very happy about the extra beds. But these experts also stressed the need for step-down services and early interventions that help children return to a healthy life sooner and avoid hospitalization altogether. We are awaiting details on how the children’s ward at Dallas Hospital will relate to existing programs or perhaps inspire new ones.
It’s impossible not to get excited about the promise this hospital holds. Ibrahim said the center will enhance research in the field of psychiatry and become a training center for behavioral health professionals. This would satisfy an urgent need, as dozens of psychiatric beds in the state would not be used because no one would work in them.
“Not only will we build on our own training programs, but we will also connect with other academic programs and other universities in North Texas to see how we can come together and provide a comprehensive training strategy for all of these behavioral health,” Ibrahim said.
Andy Keeler, president and CEO of the Meadows Institute for Mental Health Policy in Dallas, said Dallas has accomplished mental health care professionals, but it doesn’t have the “critical mass” of people it could have with a facility like the planned state hospital.
“We have some world-class people,” Keeler said. “I am not trying to underestimate the experience we have, but we do have a few. If you have a facility like this, we can have one of the best places in the country.”
A hundred cots or so will not be enough to take care of all the children who need state help. Officials will have to figure out how to allocate limited resources among children in the general population, foster care and the juvenile system.
However, 100 Beds of Children’s Health is beds that we couldn’t count on yesterday. Every bed is a ray of hope for a family, which is why we celebrate.
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