Preserve Mental Health and Community Hospitals

I have been a nurse for decades and I am very concerned by the potential effects of Question 1 on the ER, mental health care, and community hospitals.

We already struggle with mental healthcare. Question 1 would divert nurses from treatment centers into solely hospital care, which is not a viable substitute for chronic care needs. The mental health system is not the easiest to navigate, nor is substance abuse recovery, and this mandate would only worsen obstacles to care.

Question 1 would mean longer ER waits. The opioid crisis and the closing of Massachusetts psychiatric hospitals has already strained emergency rooms. While I am concerned for all patients that will have excessive wait times, longer wait times would particularly impede delivery of care to this vulnerable population. When someone is in a mental health crisis, they need to receive care immediately. Lack of timely treatment will harm the patient, their loved ones and our communities. It is imperative that mentally ill patients be seen as quickly as possible when they reach out for help from an emergency room.

We don’t have enough nurses in Massachusetts, so where are we going to find additional qualified nurses? Would we have to pull nurses from community-based specialties, such as nursing homes and home care? How will community hospitals pay the fines demanded by Question 1, and how many more community hospitals will close because of this? 

Nurses need to be able to use their judgment to determine staffing needs, such as which nurse can have three patients and which can handle more at a given time. There might be communication issues or family issues that demand additional hours of work. Acuity, education, and psychosocial issues are also factors in deciding how to provide the best care.

I have spent most of my bedside career in a community hospital. Being cared for in your community is invaluable, and it is harder to feel that comfort as easily in a huge teaching hospital. I have treated neighbors, they trusted me implicitly because I knew their families, their backgrounds, even the geography of their street. Community hospitals help patients that don’t have transportation options, are intimidated by the larger healthcare system, or need to be seen in a familiar environment.

Preserve care for the mentally ill and protect community hospitals by voting NO on 1 on November 6.

Susan Higgins

Occupational Health Nurse Manager

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