Facing high overall occupancy rates and more than a dozen boarders in
its emergency department each day, the University of Colorado's hospital
decides to convert its often underutilized adult psychiatric unit to
Joining the continuing national trend of shrinking availability of
inpatient psychiatric care, the University of Colorado Hospital (UCH) stopped
admitting adult psychiatric inpatients last month and will close its 22-bed
psychiatric unit this month. The space will be remodeled to provide 18 general
medical beds next spring (see No Adverse Effect on Residency Expected).
The facility (officially the University of Colorado Denver—Health
Sciences Center Anschutz Inpatient Pavilion), located in the Denver suburb of
Aurora, has been widely praised as a modern and technologically advanced
facility. During the mid-1990s, the university, faced with a physical
inability to expand its facilities and thus its services at its original
health sciences campus in Denver, made the controversial decision to move the
health sciences campus—including the hospital, outpatient services, and
many of the affiliated academic programs—to the expansive grounds of the
former Fitzsimmons Army Medical Center, which was closed in
The University of Colorado's Anschutz Inpatient Pavilion, part of a $1.5
billion 21st-century health sciences center, opened in 2004. Until a second
patient tower can be built (2011 at the earliest), the hospital says it has no
space for an adult inpatient psychiatric unit.
Photo Credit: University of Colorado Denver
However, space constraints once again became obvious, soon after the first
of two planned patient towers opened in January 2004.
“From the day we opened our doors,” noted UCH Vice President
for Clinical Affairs Greg Stiegmann, M.D., “we were overwhelmed with
patients that, frankly, we didn't expect to have.” Stiegmann told
Denver-area media that the 410-bed facility has been averaging around 85
percent occupancy for the last year. Over the last six months, an average of
between 15 and 20 patients each day have been boarded in the facility's
emergency department, waiting for medical or surgical beds to become
“There just aren't enough beds,” Stiegmann said after the
pending psychiatric-unit closure was announced by the hospital's board on
September 30, 2008.
In explaining the unit's closing, Jacque Montgomery, director of public and
media relations for UCH, told Psychiatric News that “the 22-bed
psychiatric unit has averaged about 16 patients per day [73 percent occupancy]
and housed only 13 or 14 patients per day [64 percent occupancy] during the
week the closure was announced.” During 2007, the hospital logged 735
adult inpatient psychiatric admissions, compared with total hospital
admissions of more than 19,000.
The decision to close the unit was not one the university reached easily,
A statement released by the hospital's Board of Directors emphasized,“
Our commitment to serving our community remains strong despite this
difficult decision to close the inpatient psychiatric unit. Ever-increasing
demand for hospital services, especially in the areas of cancer, transfers of
the severely ill, and emergency services, has forced us to carefully evaluate
the best way to care for the greatest number of patients. Hospital
administrators and this Board have explored many other options and, after
giving careful consideration to the overall bed shortage we have been
experiencing, we support the decision to convert the inpatient psychiatric
unit of our hospital.”
Montgomery noted that the hospital's board fully understands that the
planned remodeling is only a temporary solution to the space concerns.
However, construction of the hospital's second patient tower is not expected
to get under way for at least two years. At that point, the hospital may be
able to reopen an adult inpatient unit.
Meanwhile, the hospital's outpatient psychiatric services will continue,
Montgomery added, and could possibly be expanded. In addition, the closure of
the inpatient unit is not expected to adversely affect the University of
Colorado School of Medicine's psychiatric residency program.
As expected, the closure announcement was not greeted warmly by many.
Mental Health America of Colorado noted that research it compiled shows that
there are more than 40,000 emergency-room visits each year in the seven-county
Denver metropolitan area involving mental health crises. Of those, about half
involve patients needing inpatient care. Yet the metro area only has about 250
available beds—of which the UCH unit represents roughly 10 percent.
Colorado's first lady, Jeannie Ritter, a long-time mental health advocate, has
been working to find solutions to the state's psychiatric-bed crisis. She has
been working closely with nonprofit agencies to raise the funds needed to
lease space and open a 24-hour mental health crisis center on the grounds of
Denver's former Beth Israel Hospital. Hoping to have the unit up and running
by next month, Ritter had secured commitments by mid-November 2008 for less
than half of the estimated $3.5 million needed.