North Shore Medical Center project underway to increase number of psychiatric beds

Robert Caggiano, Ed.D., executive director, North Shore Medical Center

North Shore Medical Center received approval from Massachusetts state regulators to increase its number of psychiatric beds.

Plans for what will be called the Epstein Center for Behavioral Health include a total of 120 adult, geriatric, and pediatric beds. The facility is slated to open this fall.

The expansion project had a few glitches after the hospital and its parent company, Partners Healthcare, scaled back the plans in 2016 because of financial losses.

Now back on track, the expansion is an attempt to tackle what is a nationwide issue—having enough psychiatric care available so that patients don’t end up in emergency rooms.

“The expansion is primarily to meet the behavioral health and substance use disorder needs of the North Shore and surrounding communities in a newly renovated facility with great access to outdoor space,” said Robert Caggiano, Ed.D., executive director of psychiatry at North Shore.

“The support and collaboration from the department of psychiatry at Mass General Hospital on this has been instrumental.”

The additional beds are one phase of a grander $207 million expansion plan on the Salem, Mass. campus, according to North Shore’s web site.

The facility’s psychiatric beds will be a combination of 54 new beds and 66 existing beds re-located to the Spaulding North building. Caggiano explained why the hospital’s expansion is necessary.

“We currently have 25 patients today that need psychiatric beds and we don’t have beds to give them,” he said. “Adding more beds is not a quick fix but a step in the right direction.”

North Shore is not the only facility struggling to meet the demands of behavioral health issues. In Massachusetts, several projects were recently completed to expand emergency departments buckling under the pressure of excessive wait times: Lahey Hospital & Medical Center in Burlington, Tobey Hospital in Wareham, and Baystate Wing Hospital in Palmer are a few examples.

In early April, Boston’s Brigham and Women’s Hospital kicked off a $52 million project to expand its emergency department to 51,000 square feet and 30 more beds with a separate area for behavioral health patients.

David Matteodo, M.P.H., executive director of Massachusetts Association of Behavioral Health, said the increased demand for inpatient care should come as no surprise. Most hospitals run “at capacity or close to it.” As a result, it’s not just hospital expansions happening across the state.

“We’ve opened five new hospitals since 2015,” he explained. “High Point in Middleborough is now a 70-bed operation. Southcoast in Dartmouth now has a total of 140 beds. There’s TaraVista [with 100 beds] and Westborough [with 152 beds]. And, Worcester in partnership with UMass just opened in February with 120 beds.”

The expansion trend is catching on across the country, and in many cases, the emergency department is the first line of defense.

According to a March 29 article by Kaiser Health News, hospitals are opening emergency units designed to stabilize and treat patients with mental illness.

Known as “psychiatric ERs,” they not only have medical staff but also psychiatric nurses and clinicians who treat patients with the goal of releasing them within 24 hours.

In North Shore’s emergency department, eight beds will be set aside specifically for behavioral health needs to make the transition to the psychiatric unit smoother.

The eight beds may seem too few to handle the influx of patients, but the hospital has to balance the enormous need of beds in the ER for medical reasons. To Caggiano, increased bed space means more effective health care.

“There are a lot of people stuck in the North Shore area in EDs. Increasing beds makes a big difference,” he said. “This is about trying to stop downward momentum and get people set up in an outpatient program.”