In the last several years, the number of beds at the state-run psychiatric hospital at Fort Logan has dropped from 222 to 94, forcing the mental institution to admit only patients with the most severe illnesses.
Yet while the overall level of severity of patients with psychosis, schizophrenia and bipolar disorder has increased, the staff-to-patient ratio has not budged.
Five staff members per shift run each 24-patient unit at Colorado Mental Health Institute at Fort Logan in south Denver.
“We are working with some very challenging clients with the same staffing ratios that we’ve always had,” said Dr. Christopher Burke, hospital director. “When folks are more ill and require more attention and more care, it demands greater attention from staff.”
The Colorado Department of Human Services, which oversees the Fort Logan hospital and the state mental institution in Pueblo, is reviewing a consultants’ report completed last month that says the state would need to increase psychiatric beds at both hospitals by 90 percent in the next 10 years just to maintain the status quo. That’s an increase from 545 beds today to 1,033 beds by 2025.
The report could boost future requests to state budget makers for mental health funding.
It’s unclear whether human services officials would request funds to improve the staff-to-patient ratio.
“It’s definitely a challenge,” Burke said. “I realize the state doesn’t have unlimited dollars.”
As the number of beds shrunk, Fort Logan became more selective about which patients to admit. Those deemed stable enough to get help at community mental health centers, such as the Mental Health Center of Denver, are sent there instead.
Major cuts at Fort Logan in 2010 and again in 2011, after severe economic downturn, closed units for children, adolescents and geriatrics, as well as a day program.
Admissions to Fort Logan dropped 72 percent from 2005 to 2014, from 1,548 patients to 436, according to the report from the Western Interstate Commission for Higher Education.
This was even starker than the 40 percent drop in admissions to the state mental hospital in Pueblo during the same nine-year period, from 1,745 patients to 1,044.
The state pays for the care of patients at the hospital through its general fund, unless they are under 18 and have Medicaid or are older than 59 and have Medicare. When hospital beds were reduced, the state allocated funds to community mental health centers to pick up the slack, although the centers still are overburdened by people seeking care.
The majority of patients at Fort Logan are involuntarily committed, meaning they were certified as incompetent by a court or were placed on 72-hour psychiatric holds by doctors who determined they were suicidal or homicidal.
The average daily waitlist to get into Fort Logan is 10 people, ranging from seven to 15. Priority is given to those at hospital emergency rooms, where people who are suicidal or are having severe anxiety often go for immediate help.
“They will be in the emergency departments, queued up,” Burke said.
Fort Logan patient Christopher White came to the hospital after numerous stints in the downtown Denver jail for trespassing, as well as visits to Denver Health Medical Center’s psychiatric department. White has psychosis and schizophrenia, and he is homeless. When he is not taking his medication, which he rarely does while living on the streets, the voices in his head tell him where to walk and how to crack the codes to find the anti-Christ.
A new voice, named Mikey, recently joined the others, and he is there despite the injections of Abilify, an antipsychotic, that White received during his month-long stay at Fort Logan.
“I’m going to continue to take my meds,” White said the day before his release, but then he added, “The baby of the west has 16 letters.” The baby is Mikey, and the letters comprise one of White’s codes.
White was arrested at a bus station in Boulder “because Mikey was acting up,” and he was asking people there to look into his eyes, he said. He spent time at Centennial Peaks treatment center in Louisville before he was admitted to Fort Logan.
Fort Logan staffers linked White with services and a shelter run by the Mental Health Center of Denver. Before he left the hospital, he wrote a letter to Denver County Judge Johnny Barajas, who presided over some of White’s criminal cases last year in a special courtroom for people with mental illness.
“I hope your heart smiles like mine,” White wrote. “I’ve accepted that I have a mental illness, not that I’m wrong or right, but it’s a rare illness that no one has discovered, not even me, because it’s a higher power named Christ Jesus.”
Jennifer Brown: 303-954-1593, jenbrown@denverpost.com or twitter.com/jbrowndpost
