Throughout Arkansas, healthcare providers are innovatively adapting to the challenges of providing behavioral health services that run the gamut from caring for the severely mentally ill in hospitals to providing an Employee Assistance Program (EAP) used by businesses to include counseling in benefits packages.

Psychiatrists are in short supply, particularly in rural areas, which makes staffing for behavioral health services challenging.

“As the need for inpatient psychiatric care grows, we are finding it more difficult to find psychiatrists who are interested in practicing as an in-patient care provider,” said Bob Burchfield, system director of Behavioral Services at Baptist Health, which has 19 psychiatric intensive care beds and 16 geriatric beds at their Little Rock facilities, 24 adult beds at their Malvern Hospital (Baptist Health- Hot Spring County), and eight beds at their geriatric unit in Baptist Health-Stuttgart.

“We have addressed this by employing physicians and mid-level practitioners (APN's and PA's). We are able to offer predictable income for our practitioners and allow them to focus on treating patients without the hassle of having to navigate through the ever-changing regs regarding billing for services. They report the stable income, along with health insurance benefits, retirement, and paid time off as real benefits for being a staff psychiatrist here at Baptist Health.”

Burchfield said they are facing the same on-going challenges as other providers meeting the needs.

“We are all competing for the few spots available,” he said. “Couple that with the few beds available at the Arkansas State Hospital, and we find ourselves struggling to get patients to the most appropriate care, especially those with chronic mental illness. We are exploring new ways for patients to access care by the use of new technology, particularly telemedicine. We hope this will get our patients plugged in to outpatient care more readily available through this new technology. It really is incredible, the possibility to reach those who need help, but find themselves in rural areas with little or no outpatient services.”

The UAMS Psychiatric Research Institute (PRI) is one of nine facilities of its kind in the U.S. It is working to change the way mental illness is treated as well as perceived in today’s society, said PRI Director of Nursing Judy Seidenschnur, RN.

“The treatment model places a heavy emphasis on the relationship between mental and physical health and patient and family centered care,” Seidenschnur said. “In the treatment model of the inpatient units, psychotherapy in conjunction with psycho-educational activities is provided by a multidisciplinary team comprised of MD’s, APN’s, other nurses, social workers, nutritionists, occupational and speech therapists, pharmacists, psychologists, health educators and chaplaincy staff.”

The PRI inpatient units have a total of 40 beds providing specialized care to women, children and adult patients.

The Women’s Unit provides individualized behavioral healthcare for issues unique to the female patient. The focus of patient and family centered care is provided in a secure, strong and supportive environment with an average length of stay of 5-7 days.

The Child Unit is a diagnostic center providing intensive evaluation and treatment for young children ages 2- 12 years. It is dedicated to patient and family-centered treatment using the Collaborative Problem Solving Model with the philosophy that a “child will do well if they can.” The length of stay is 28 days.

The Adult Unit serves patients with acute psychiatric needs and major psychiatric disorders.

“The significance of medication compliance and lifestyle modifications is emphasized,” Seidenschnur said. “Patients participate in psycho-educational groups related to medications, diet, physical and sleep hygiene and healthy recreational activities. The length of stay averages 6-7 days.    

“The three inpatient units provide state-of-the art comprehensive mental health services for the citizens in the state of Arkansas. The inpatient services stand out as a leader for patients struggling with mental illness.”

CHI St. Vincent Behavioral Health Center has 49 beds in Little Rock at the CHI St. Vincent Infirmary and 21 geriatric behavioral health beds at the CHI St. Vincent Hot Springs.

“At CHI St. Vincent Infirmary, we carefully plan and carry out therapy and treatments that are individualized for each patient with the goal of having the best possible outcome,” said Shawnte’ Hill, BSN, RN, nurse manager, Behavioral Health, CHI St. Vincent Infirmary. “And while individual therapy is important, our patients also benefit from daily focus groups and therapy sessions with other patients. Also, because we know that families have a stake in the care of our patients, we provide an option of including family members in therapy sessions. Therapy and appropriately administered medication are how we focus on the whole person – body, mind and spirit.”

St. Bernards Behavioral Health services provided at the 60-bed inpatient unit in Jonesboro include individual therapy, group therapy, family therapy planning, activity therapy and medication management.

“St. Bernards also operates the St. Bernards Counseling Center that offers two intensive outpatient programs, one on eating disorders and the other on chemical dependency,” said Kevin Byron, director of St. Bernards Behavioral Health. “Services also include outpatient therapy for grief management, marriage problems, gambling issues, depression and anxiety.”

Also offered is an Employee Assistance Program (EAP) used by businesses to include counseling and therapy services in benefits packages for their employees. The employer-funded EAP provides six therapy sessions each year for an employee and his or her family.

Byron said Bernards plans early this year to begin offering a new non-invasive, non-systemic outpatient procedure that has been proven to reduce and/or eliminate symptoms for patients who have clinical depression and have not achieved desired symptom relief with other forms of treatment. Called Transcranial Magnetic Stimulation (TMS), the therapy uses magnetic pulses in a series of short treatments over the course of 10 to 12 weeks and will be administered at the Counseling Center under the supervision of a psychiatrist.

“St. Bernards will be one of the few sites in Arkansas that offers TMS,” Byron said.

Nick T. Ogle, PhD, LPC, director of Mental/Behavioral Health Services at Mercy in Lowell, said the facility is staffed by three psychiatrists and other professionals who currently serve roughly 282 people per week.

“We have a waitlist of more than a year to get in with a psychiatrist,” he said. “We can get someone in with a therapist within three weeks. Our outpatient program provides services for people suffering from/dealing with all different kinds of issues.”