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CRHC adds to mental-health services

Clarinda Herald-Journal - 6/14/2018

Clarinda Regional Health Center is using technology to link mental-health care providers to patients who need an evaluation.

"That has been our newest option," said Renee Nauman, director of med surg for the emergency room.

When a patient shows signs of a mental-health issue, center staff can use a video and audio connection to Heartland Family Services in Council Bluffs and its mental-health providers.

"It acts like Skype," Nauman said, "a video communication with a provider. The provider speaks with the patient for an assessment. Heartland then sends us a summary and recommendation to us for treatment."

Clarinda Regional Health Center does have local options for mental-health cases. Nauman said Southwest Iowa Families and Waubonsie Mental Health can assist with center patients they have already worked with before.

Nauman said an emergency room doctor can contact either place to inform them about the patient's situation.

"We do see what they recommend. Do they go home? Do they (Southwest Iowa Families or Waubonsie) want to see them the next day for additional treatment or should it be an inpatient level of care," Nauman said.

"The difference in ER is the ability to intervene if it comes down to a risk to themselves or someone else," she said.

Past cases have included people stating they see or hear things that don't actually exist.

"Often times, these people are seen in the community talking to themselves or imaginary people. That can make people uncomfortable, but that doesn't mean they require inpatient treatment."

Nauman said a small percentage of cases fully understand they are in crisis and will go home voluntarily.

More cases involve a process to find the person inpatient care, what Clarinda Regional Health Center cannot provide.

"We seek committal for the patient through the court system," she said.

That process involves the court system or judge to determine if the patient needs a committal.

"If it is a committal, then we go through the process of finding a bed. That's become very difficult," she said.

There are facilities in Nebraska and Missouri, but a patient can only go across state lines for treatment on their own or through a court-appointed guardian.

Most cases at Clarinda Regional Health Center are not like that.

"If they have to stay in Iowa, we start close in finding a bed then work our way out. We can get lucky and have them in Council Bluffs in a couple hours," Nauman said.

Clarinda Regional Health Center isn't always that lucky.

"It's usually a three to eight hour search to find a bed, even before they leave Clarinda. They stay in the ER until a bed is found," she said.

And when that bed is located, which has been as far as Davenport for some people, the sheriff's department is required to transport the person to the location.

"It's not a daily thing," Nauman said about the frequency of finding a provider for mental-health cases. "But holidays are usually harder on people, especially from Thanksgiving on to the rest of the year."


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