In the face of persistent funding challenges, Axis Health System is reshaping its behavioral health crisis services.
The nonprofit closed its Acute Treatment Unit on Tuesday and replaced it with a Walk-in Crisis Center.
The health system is adamant that while the closure of the Acute Treatment Unit is a loss, the changes will add and expand mental health services in other ways.
The Acute Treatment Unit, which opened in 2006, provided a high level of care for people experiencing a mental health crisis. Patients deemed clinically appropriate could stay for up to seven days without being admitted to a hospital.
Axis spokesperson Haley Leonard Saunders acknowledged that while the change leaves La Plata County without a local inpatient behavioral health program outside of hospitalization, crisis services are not disappearing ‒ just changing.
The program designation will allow the clinic to more efficiently stretch its limited funds, she said.
Saunders said the Acute Treatment Unit had become financially unsustainable. The level of care requires significant staffing even when no beds were filled and is expensive to operate. At the same time, private insurers do not usually reimburse the costs. Admittance to the unit represented only about 2% of all crisis contacts handled be Axis, she said.
The new designation as a walk-in crisis center allows Axis to keep patients on-site for up to 23 hours while staff complete mental health assessments, coordinate care, develop safety plans and arrange placement if a higher level of treatment is needed.
Previously, people experiencing an after-hours behavioral health crisis often remained in a hospital emergency department or at home while Axis’ mobile crisis team responded and developed a treatment plan, Saunders said. Since the center was not designated as a “walk-in,” people could not actually wait at the clinic.
If inpatient care was needed, patients typically waited in the emergency department until a bed became available, she said.
“The majority of people who have a crisis episode, even if they are in the ED, do not end up needing a higher level of care,” Saunders said. “If we can pull people out of that heightened environment, it really contributes to a better experience.”
The change also expands services available through the crisis center. Axis plans to offer rapid-access psychiatric care and medication assisted treatment on demand, services that were previously unavailable in the crisis setting on demand.
Patients who would have previously qualified for the Acute Treatment Unit will continue to receive care, she said. If a higher level of treatment is necessary, Axis staff will coordinate placement at another facility, including the crisis stabilization unit in Montrose, which Saunders said can typically keep patients for up to five days.
Axis will also arrange transportation to and from the facility.
“They are not going to be left to fend for themselves,” she said.
When speaking with The Durango Herald regarding the change, Saunders was admittedly cautious and initially hesitant to focus on the loss of the Acute Treatment Unit.
The reason, she said, is a fear that too much focus on that loss will create a community-wide misunderstanding that Axis no longer offers crisis and mental health treatment.
Already, someone who had heard the Acute Treatment Unit was closed thought that applied to the entire mental health service center, and drove elsewhere, Saunders said.
Driving to Montrose as the next best option for patients who need higher-level care is tough, and Axis, in a perfect world, wouldn’t want anyone leaving the area, she said.
“It’s certainly a loss for us and the team but we had to make a really hard decision, and fortunately we’re able to move some of that funding and expand our crisis services differently,” she said.
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