SEATTLE — UW Medicine will close Seven North, a psychiatric facility at UW Medicine — Montlake, laying off staffers and reducing the number of inpatient beds available to those in need of care amid the state’s mental health crisis.
“They are going to officially close the unit,” said Tina Mankowski, a UW Medicine spokesperson. Twenty-three jobs are being cut, though employees could fill open roles elsewhere in the UW Medicine system.
The Washington State Nurses Association (WSNA), which represents Seven North nurses, issued a statement calling for UW Medicine to “reverse course and re-open this facility.” Negotiations over layoffs will begin Monday, said Heather Vargas-Lyon, a nurse who will participate in bargaining.
The financial upheaval that has accompanied COVID-19 prompted the closure of the facility, which serves people who admit themselves voluntarily. UW Medicine announced last month it faced a $500 million shortfall. The organization spent unplanned funds on testing and equipment for COVID-19 at the same time it was losing millions on elective procedures. Beginning March 19, Gov. Jay Inslee halted many surgeries statewide for weeks to try to prevent the spread of COVID-19 and preserve protective gear for health workers fighting the pandemic.
Mankowski said UW Medicine has not identified plans for the Seven North facility, though the space was factoring into the hospital system’s preparation for future, possible surges of COVID-19 patients.
Seven North, which has been closed to patients since late May with workers furloughed, is licensed to operate 14 inpatient beds, but has recently operated only 10.
Patients who once would have been served at Seven North could receive care at UW Medicine — Northwest, which operates a 27-bed psychiatry unit that specializes in geriatric patients.
UW Medicine — Northwest recently reduced the number of beds available for geriatric care by seven. Those seven beds are now available to adults of all ages voluntarily seeking mental health care, the type of patients once served by Seven North.
UW administrators argue the consolidation is a sensible cost-cutting move given the institution’s dim financial picture.
Seven North loses about $1.5 million a year, said Dr. Jurgen Unutzer, professor and chair of psychiatry and behavioral sciences at the University of Washington.
“In times when we had a better financial situation, we could absorb the loss better. At this point, when we have to dramatically reduce our costs, they (administrators) cannot support it,” Unutzer said. “Nobody is feeling good about this.”
Nurses say the financial arguments fall flat because administrators have previously told them that Seven North would pencil out if the unit admitted up to 14 patients, and UW Medicine had planned to scale upward until the pandemic’s disruptions.
“Part of the reason they believe closing Seven North is the right decision is that the cost of operating a unit with the bed capacity of 10 is too high and too expensive,” said Caitlin Sellhorn, a nurse. “We’re told that 14 is the number that would make us break even. We’re licensed to 14, but they’ve declined to admit that many patients.”
According to the nurses association, no other psychiatric facility in the state offers the same type of treatment for pregnant women.
“I just don’t see how they could take care of a high risk pregnant patient” at UW Medicine — Northwest, Vargas-Lyon said. “They need specialized care their entire hospitalization.”
The nurses also worry about impacts at UW Medicine — Northwest.
As UW Medicine reduces geriatric psychiatry beds at UW Medicine — Northwest, the organization also wants to bring down the length of time geriatric psychiatry patients stay there. (Seven North nurses were skeptical of the initiative. “There’s not enough beds in adult family homes,” Sellhorn said. “There’s a big shortage of places to discharge these patients to.”)
Washington state has struggled with providing mental health care capacity, which leaves patients languishing while waiting for space.
Vargas-Lyon said she expected the closure of Seven North to lead to “an increased number of psychiatric patients boarding in restraints in hospital emergency rooms.”
Unutzer agreed the community lacks resources for behavioral health.
UW Medicine is planning a new, 150-bed behavioral health facility at its Northwest campus. The University of Washington Board of Regents in May approved its construction site and a budget, pending additional funding from the state Legislature, which already has appropriated more than $33 million for design.
Amid the pandemic, financial uncertainty and increasing tensions over racism and inequality, Unutzer said he expects an increase in people struggling with mental health and substance abuse.
“We have this crazy combination of clearly increased need, especially in our area, and all of a sudden this giant loss of resources and we have to somehow find our way through this,” Unutzer said.
