Addiction and mental health treatment programs struggle with staffing amid COVID surge

With coronavirus infections surging in Massachusetts, some addiction and mental health treatment programs are especially hard hit. Many are reverting back to policies put in place early in the pandemic, such as telemedicine. Some have stopped accepting new patients altogether.

High Point Treatment Center, headquartered in Brockton, has temporarily closed admissions to all of its programs because of increased infections among patients and staff. Patients seeking treatment are referred to a hotline run by the state Bureau of Substance Addiction Services (BSAS).

"High Point’s admissions team provides all callers with the BSAS hotline,
but with many programs not accepting admissions, there isn’t much that can
be done at the present time," said Hillary Dubois, chief of communications and prevention services for High Point. "While the pandemic is a major health crisis,
individuals struggling with their substance use/mental health appear to be
impacted the most."

High Point served nearly 20,000 patients in all of its programs in the last fiscal year, and Dubois says this is the most significant disruption in its services since the pandemic began. Even pre-pandemic, Dubois said the admissions department typically fielded 50-100 calls a day for inpatient services that it could not meet.

Spectrum Health Systems, another large addiction treatment provider which operates 15 sites in Massachusetts, said about one third of its staff is out this week because of the surge in COVID infections. The lack of staffing forced Spectrum to close a 20-bed program in Westboro for a few days this week, but it has been able to keep other programs operating.

"This latest surge is like nothing we have seen in the past one to two years," said Dr. Jeff Baxter, chief medical officer for Spectrum. "It's impacting not only our patients, but our staff. And so it's even more challenging now than it was in the early phases of the COVID pandemic."

Aside from stringent testing and masking requirements, Spectrum is moving to more telehealth services and limiting communal activities in its residential programs. Baxter said he and other administrators are also taking on some clinical work because so many workers are out.

"It's all hands on deck," Baxter said. "We're scrambling to keep beds open, and if we're going to keep them open, we have to have a basic amount of staffing to ensure safety. As more and more of our staff and their families are impacted, that's going to be harder and harder."

Spectrum runs one of the few addiction treatment programs in the state that also cares for patients who are seriously ill with COVID-19. Baxter is concerned that as the virus spreads further, there are not enough of these programs to help contain infection rates.

"There is still a great need across the state for safe places, for people to go to isolate once they're positive," Baxter said. "And I think there's still an acute shortage of safe housing, whether temporary or longer term, to try and contain the spread of this virus."

On Cape Cod, infections among staff have forced Gosnold Treatment Center to temporarily close admissions at times, but the center has kept its programs open. Gosnold President and CEO Richard Curcuru says retaining staff is a huge issue, and he's increased workers salaries three times in the past year.

"Hiring staff has been a real challenge," Curcuru said. "We have the added problem of being on Cape Cod — even in the best circumstances it's hard to hire staff down here. There is a lack of people willing to work in congregate programs and our rehab programs."

In an effort to prevent the spread of the virus, Gosnold is moving back to telehealth for services such as meetings and counselor appointments starting Monday. Addiction treatment programs at Boston Medical Center have made that same move.

Colleen LaBelle, director of BMC's Office Based Addiction Treatment Clinic, said that can be a challenge in treating substance use disorders, which have been an increasing concern during the COVID-19 pandemic.

"I think it's hard for patients," LaBelle said. "People need that connection, they need that contact because when dealing with substance use, it's about connectivity. So it's definitely hard for them not to have those in-person groups and in-person contacts."

Psychiatric Hospitals are also hard hit. On average, about half of the state's psychiatric hospital units have had to temporarily stop accepting new patients, according to David Matteodo, executive director of the Massachusetts Association of Behavioral Health Systems. He says that's largely because of staffing issues.

"It's terrible," Matteodo said. "Now we're really getting up to some really serious lack of access."

If a patient has tested positive for the coronavirus, access is even harder. Currently, just two psychiatric hospital units in Massachusetts accept COVID-positive patients.

Matteodo has been meeting with providers and state officials to try and come up with solutions to ride out what he hopes is a temporary surge. He said with the pandemic  worsening some mental health and substance use issues, it is again shedding light on a longstanding problem.

"The inpatient psychiatric behavioral health system, substance abuse was extremely stressed before COVID," Matteodo said. "COVID has exacerbated the whole situation. So the inpatient psychiatric system is really severely stressed right now."