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Five COVID-19 cases at state mental hospital for the elderly; ADMH intakes stopped in March

By MARY SELL, Alabama Daily News

Five patients at the state’s Mary Starke Harper Geriatric Psychiatry Center have tested positive for COVID-19 since May 1.

The positive cases came from two of four units in the hospital. Interactions among the elderly patients, many of whom have dementia, in those units have been limited, Dr. Mark Woods, medical director for the Alabama Department of Mental Health, told Alabama Daily News on Wednesday.

“You have to realize, social distancing in this population is very, very difficult,” Woods said. “You know, you don’t want to restrain or force this population that already has a major issue with confusion. Any restrictions are very difficult. Getting them to wear a mask is virtually impossible. So we just really depend on our staff to work with us and they’ve been absolutely great.” 

All staff is required to wear masks and patients are getting their temperatures taken twice a day.

Woods said the Alabama Department of Public Health is investigating the cases and trying to trace the virus’ path into the hospital that stopped visits and new admissions in mid-March. 

“I cannot say 100% where it came from,” Woods said. New admissions and visitation and the hospital has been restricted since mid-March.

Woods said he knows of two positive cases in contract staff members at Mary Starke Harper.

The five patients have been receiving care at a local medical hospital and one has already tested negative for the virus. Two negative tests will be required before patients can return to the ADMH hospital.

The most recent confirmation was on May 8. No cases have been reported in ADMH’s other two hospitals, also in Tuscaloosa, but wide testing hasn’t been done, Woods said Wednesday.

Alabama Daily News asked May 4 about possible cases and precautions taken at the hospitals. No response was given from the department until Wednesday, after a teleconference with Democratic officials in the state.

Mary Starke Harper has the ability to do on-site testing with tests from ADPH, but hasn’t tested all patients on the recommendations of ADPH, Woods said. People who were recently in close contact with the positive patients — closer than 6 feet for more than 15 minutes — have been tested and those tests have come back negative, Woods said. Patients are quarantined until their results are returned.

Mary Starke Harper has capacity for 96 patients. Bryce Hospital has 256 beds and Taylor Hardin Secure Medical Facility has 140 beds. The three have a combined staff of about 1,000, Woods said.

The ADMH on March 16 stopped allowing new patients and restricted outside visits. 

“The genesis of that is that we get (patients) from all over the state,” Woods said. “And the (COVID-19)  hotspots in the state kind of change. At one time, Opelika was a big hotspot. We had patients waiting there.”

Involuntary commitments ‘back up’

Involuntary commitments of Alabamians with mental health issues have carried on during the pandemic, with some alterations. 

Morgan County Probate Judge Greg Cain oversaw three of them on Tuesday afternoon at Decatur Morgan West Hospital, where the country contracts some mental health services.

Attorneys and ad litem guardians are screened and their temperatures taken before entering and social distancing is maintained, Cain said.

“We’re taking the recommended precautions,” Cain said.

And while the state hospitals aren’t accepting new commitments, crisis residential units are, Cain said.

When the state closed three mental health hospitals in 2012 and 2015, more committed patients were sent to designated crisis residential units. There are about 215 beds at small facilities around the state. They get state funding, but are not operated by ADMH. Even prior to COVID-19, some judges had said finding space for committed mental health patients was a challenge.

“We have people backed up into acute facilities,” Tuscaloosa County Probate Judge Rob Robertson said Tuesday about the admission stoppage at the three state hospitals.

“The biggest issue is not being able to get (patients) placed,” Robertson said. “That ties up finite resources. I hope (state hospitals) start accepting patients soon.”

Robertson said he hasn’t seen a change in the number of involuntary commitments since the pandemic hit Alabama, but said the effects of stay-home orders, including disruptions of regular activities and care, “exacerbates pre-existing conditions.”

In Calhoun County, Probate Judge Alice Martin said voluntary commitments are going to a 16-bed CRU in Alexandria.

“We’re fortunate to have local resources,” Martin said. “We have continued to have commitment hearings, just as we have always done, and try to find resources for people who need mental health treatment.”

And unlike some counties, Calhoun County has two mental health officers who are doing welfare checks on residents with known mental health issues, Martin said.

Woods said he didn’t know when the three state hospitals would again accept new patients.

“You know once (COVID-19) gets inside your facility, it’s hard to stop it,” Woods said. “So, in order to keep a sterile environment, we stopped that until we can see the curve turning and now that we’re hopefully seeing the curve turning, we’re working on what to do about getting the community some help.

“… We’ve got several plans were working on. My big fear is now that the state has lessened the constraints, that we may have a next wave. And so I want our plan to be very solid to protect our facilities.”

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