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Solomon outpatient
clinic is closing
(May 2003
Issue)
By Sean Smith
The announcement in early March that Lowell Massachusetts' venerable
Solomon Mental Health Center outpatient program would be shut down
this spring stunned patients and advocates alike.
"Where are these people going to go?" a spokeswoman for the National
Alliance for the Mentally Ill's Greater Lowell chapter asked the
Lowell Sun, echoing a comment voiced by others. She termed the state's
decision to close the program and refer its 464 patients to private
providers as "horrible, insane and ridiculous."
But whatever adjectives one chooses to describe the plan, it appears
to be on track for completion. Interviewed in early April, state
officials note about 250 patients had been successfully referred,
and they expect that remaining clients will be assigned to new providers
by the end of next month.
Officials refute concerns expressed by advocates and patients that
private providers could not handle the influx of new clients. "That
has not been our experience," says Carla Saccone, director for the
Department of Mental Health Northeast Area, which encompasses Lowell.
"The clinics have been willing and able to take on the patients
who have been served by Solomon, and we are confident that this
will continue."
The outpatient clinic at Solomon amounted to duplication of services
that are available through community-based providers and closing
the clinic would save the state about $1 million, according to Donna
Rheaume, spokesperson for the Department of Health and Human Services.
Although there had been signs that the outpatient clinic's existence
might be in jeopardy, David Atkins, M.D., who has been the Solomon
Center medical director since March of last year, says the decision
nonetheless "came as a shock" to the Solomon staff.
"Understandably, we have had some strong reactions from clinicians
here, about their patients' as well as their own situations," he
says. "But people have shown a great deal of professionalism in
helping make the transition go forward."
One provider taking on the Solomon patients is Greater Lynn Mental
Health and Retardation Association, which has a short-term contract
with the state to arrange the transition. The association's CEO,
Paul Cote, did not return phone calls from New England Psychologist.
Others accepting referrals include Arbor Counseling, the Center
for Family Development, Mental Health Associates and the Greater
Lowell Psychiatric Association. Since arrangements for transportation
are included as part of a treatment plan, Saccone says, patients
should experience no difficulty traveling to or from their new providers.
"The Solomon Center is actually not the most conveniently located
place for people to get to," says Saccone. "In some ways, these
new providers make transportation even less of an issue."
Officials also point out that while the outpatient clinic is being
discontinued, the Solomon Center itself will not shut down. "The
case management team will continue to work there, so people who
need help will still be able to get it," says Saccone.
Saccone says the Solomon outpatient clinic closing reflects a long-term
trend in decentralizing state-run mental health care services, one
that long precedes the Romney administration. "It's important to
remember that there are only three areas in Massachusetts that have
a state-operated outpatient clinic," she says. "We have had success
before in referring clients previously served by such facilities
to other providers."
Albert Scott, LICSW, executive director of the private non-profit
Mental Health Association of Greater Lowell, says that while Solomon's
outpatient counseling does represent a duplication of services,
the center's presence in the therapeutic community cannot be easily
dismissed.
"They've been around for some 30 years, and have done important
work for the seriously, persistently mentally ill," says Scott,
whose organization earlier this year took on DMH clients served
by Solomon, a move preceding the announcement of the clinic's closing.
"No other clinics have the specialization and the resources that
Solomon has. If someone missed an appointment or came late, a clinician
would still see them. They never terminated a client. "I just don't
see how this transfer is going to work in the time-frame they've
suggested. A year to 18 months, maybe, but not in a matter of weeks
and months."
Atkins notes that the center has already undergone significant
changes in its philosophy, including the closing of its inpatient
unit some years ago. "Many of the outpatient clinicians worked in
the inpatient unit, and they wondered if some day this might happen,"
he says. "In some ways, people had been hopeful that we'd have a
new service mission."
A more recent shift, he says, came when the center blended outpatient
services with a community rehabilitation support model. "Fifteen
years or so ago, when Solomon did outreach in shelters and residential
programs, there was no comparison," he says. "But in recent years,
that was no longer such a distinguishing characteristic; in some
ways, there are community providers who do more outreach than we
do, such as visiting patients or providing service outside of ordinary
hours."
While Atkins expressed optimism about the transition, he emphasizes
that it is not a process done on the fly. "This is a huge undertaking
for the patients, especially those who have been coming here a long
time. It takes a lot of tact and care to think about and discuss
matching them with the agency that best serves their needs, and
how to initiate the change: Do you go with them to their first appointment
with the new provider, or is it better to hold the meeting at Solomon,
which will be a more familiar setting?
"People are taking this very seriously, and will continue to ensure
that the patients get the best care possible."
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