NASHVILLE, Tenn. (WTVF) — It's hard to get mental health treatment even if you have insurance.
But a NewsChannel 5 investigation has found people without health insurance can wait days in Emergency Departments to get into a psychiatric hospital.
In 2021, Tristar Centennial Medical Center in Nashville paid $725,000 to settle allegations of "patient dumping" following an investigation by the U.S. Department of Health and Human Services.
The investigation focused on 29 patients who came to the hospital's Emergency Department in 2016 and 2017 with serious psychiatric medical conditions.
Investigators found although the hospital had available staff and facilities to treat the individuals at its on-site psychiatric unit, it either discharged the patients or held them in the Emergency Department for up to six days until space became available at a state-run psychiatric hospital.
The investigation cited the case of a 39-year-old woman brought to Tristar Centennial by ambulance.
J.A., as she is identified in the investigation, was "found walking through traffic" with complaints of "psychosis."
J.A. did not have health insurance.
Instead of admitting the woman into Centennial's on-site psychiatric unit, Parthenon Pavilion, she was forced to wait in the hospital's Emergency Department for three and a half days - for a room to open in a state-run psychiatric hospital.
In a statement, Tristar Centennial said they've improved care since the investigation and "do not believe this history is reflective of the current state of mental health care in our ER."
Tristar Centennial also said, "The increasing need for mental healthcare services is a challenge faced by healthcare providers across the country."
Emergency room doctors say mental health patients without insurance often wait days to get into a psychiatric hospital, especially in the midst of the current mental health crisis.
"In the state of Tennessee, we have a lack of capacity for those uninsured patients," said ER Doctor Sudave Mendiratta.
Mendiratta is past president of the Tennessee College of Emergency Physicians which represents all ER doctors across the state.
"The wait times that you are seeing your investigative reporting are not unusual for people across the state of Tennessee in acute mental health crisis without insurance," Dr. Mendiratta said.
As we first reported, Helen Moore waited four days inside a locked room in the Emergency Department at Manchester's Unity Hospital.
She was suicidal, but she did not have insurance.
The hospital told her she was 35th on the waiting list for a bed at Moccasin Bend, a state-run psychiatric hospital.
"I just wanted help, and I felt like I was being thrown away," Moore said.
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"When you are in a mental health crisis you need help then, the same as having a heart attack or stroke," Moore continued.
Therapist Suzanne Blackwood was surprised when a state crisis worker recently kept asking whether a suicidal 19-year-old client of hers had insurance.
"It was one of the first questions asked after I called," Blackwood said.
"It became a major issue in the middle of a mental health emergency. The focus was on whether she had insurance," Blackwood said.
When the crisis worker finally discovered the 19-year-old was still on her parent's insurance, the patient was quickly admitted to a private psychiatric hospital according to Blackwood.
"The crisis worker indicated to me that where my client was placed depended on whether she had insurance," Blackwood said.
Blackwood believes what is happening today is similar to that what federal investigators found Tristar Centennial doing years ago.
There are 49 inpatient psychiatric hospitals in Tennessee according to the Department of Mental Health and Substance Abuse, but most are privately run.
Only 4 are state-run and routinely accept patients without health insurance.
Unity Hospital in Manchester, where Helen Moore waited, does not have an onsite psychiatric unit.
Unity's Chief Manager, Bappa Mukerji said it's not uncommon for uninsured patients to wait for days in their ER.
"Emergency rooms have become the dumping ground for those patients, and we are required by law to take care of anyone who comes into our emergency room," Mukherji said.
He said the uninsured mental health patients wait for a bed to become available at Moccasin Bend, the nearest state-run psychiatric hospital.
"If you don't have insurance that is the place that you pretty much have to go because there is no private psychiatric facility that generally accepts uninsured patients," Mukherji said.
But it can be tough to find a bed even for those with insurance.
There are 2,928 licensed psychiatric beds in Tennessee, both public and private.
However, 675 of those beds are unstaffed because of a worker shortage, so they can't be used according to the state.
In the recent special session lawmakers approved one-time money designed to staff some of those empty psychiatric beds.
It included $12 million for signing and retention bonuses for mental health professionals.
It also included $20 million to help repay student loans for mental health workers.
The concern for many is those are long-term solutions, and the crisis is right now.
Here is the full statement from Tristar Centennial:
The increasing need for mental healthcare services is a challenge faced by healthcare providers across the country, and the mental health and well-being of our community is very important to us. We provide a full medical screening exam to every patient with mental health needs, and we utilize all our available resources to initiate a robust treatment plan to stabilize the patient while in the ER. Additionally, we have expanded mental health resources for the community, including partial hospitalization and intensive outpatient programs. The greater TriStar Health network is also focusing on providing additional mental health services for the middle Tennessee area, including the construction of a 60-bed behavioral health hospital in Columbia, TN which opened in January 2020.
