Concerns raised as UW psych unit slated for permanent closure

Staff and some former patients are raising concerns over the closure of a small inpatient psychiatric unit in Seattle known as Seven North.

University of Washington Medicine temporarily closed the unit at their Montlake campus in May and furloughed staff as part of an effort to address a $500 million shortfall due to costs and revenue losses associated with the pandemic.

UW officials announced this month that the closure would be permanent, with lay-offs of 23 staff members effective in mid-July. UW Medicine is working to find employment opportunities within their system for those staff members, according to a statement.

An online petition calling on UW to reopen the unit had more than 600 signatures as of Wednesday.

The closure will reduce the overall number of beds available to patients in need of psychiatric care amid a growing mental health crisis.

And it’s been lamented by the unit’s staff and some former patients, like Cindy Holcomb. In late 2010, Holcomb suffered from a bout of insomnia. She can’t remember how long she went without sleep, but she remembers the feeling.

“You feel nervous and anxious and your mind just won’t let you go to sleep,” Holcomb said. “Your mind just will not relax.”

A similar bout in the 1980s had resulted in hallucinations so Holcomb asked to be admitted to a hospital in her town in Montana.

When she was turned away, she called her daughter in Seattle, a nurse.

Holcomb said she was on a plane the next day and admitted to Seven North.

She said she felt secure there and got the treatment she needed. She said the closure of the unit is disappointing.

“It’s just a huge loss,” she said.

Holcomb’s daughter did not work on Seven North at the time she was admitted, but she does now.

Heather Vargas-Lyon is one of the staff members to raise alarm bells over the closure.

She and other staff are concerned about what will happen to the patient population, mainly made up of people seeking care voluntarily, previously served by their unit.

Seven North has capacity to serve 14 patients, but has served no more than 10 in recent times. Patient populations include UW students and high risk pregnant women who need psychiatric care.

They worry those patients won’t receive the same care and peer support in a different unit.

“It’s very short-sighted. We have a responsibility to the community to take care of these patients and they know full-well, they know, that we cannot care for these patients adequately anywhere else,” said Anne Powers, a nurse on Seven North.

But Cindy Hecker, CEO of UW Medical Center, disagrees. She said they did not make the decision to close the unit lightly and would not have done so if they didn’t think they could provide good care to patients elsewhere.

UW Medicine is converting seven beds in a geriatric psychiatry unit at their Northwest campus to take voluntary patients who might otherwise have been served at Seven North.

Hecker said it’s hard to close a unit, but the financial climate made it necessary. According to a statement, Seven North loses an average of $1.4 million per year.

“Obviously, we don’t want to lose money on this program,” Hecker said.

“I wouldn’t be doing this if I believed that we couldn’t enhance care and deliver care to these patients," she added.

Hecker said they intend to make their Northwest campus a hub for psychiatric treatment and that patients will have access to more services there.

But Seven North nurses say having a unit where voluntary patients receive care alongside those who may need involuntary psychiatric holds, and older patients who may suffer from conditions like dementia, is not an ideal environment. And staff have also raised fears about what the closure will mean for the overall system.

“We have such limited psychiatric beds in King County and I see patients boarding when I’m going to the emergency rooms, and I just can’t see how this isn’t going to further that problem and have more psych patients waiting a really long time [for a bed],” Seven North nurse Heather Vargas-Lyon said.

Vargas-Lyon’s concern about a backup in the system is shared by Molly McNamara, a social worker with UW Medicine.

She remembers a time several years ago when there were serious issues with patients boarding in emergency rooms in Washington state because there weren’t appropriate beds available. There were people lining hallways, sometimes for days, she said.

“This seems to me like a scary slide backwards,” McNamara said of the closure of Seven North.

She’s also worried about the loss of geriatric beds at the Northwest campus as those are made available for patients voluntarily seeking care.

“From what I know of the system, finding geriatric psych beds is infinitely harder than finding a general adult psychiatric bed,” McNamara said.

She said it’s a shock to hear those beds are being reduced.

But Hecker, with the University of Washington Medical Center, said some geriatric patients stay for extremely long periods of time and they believe they can shorten stays for some and effectively serve the same number of community members with a smaller number of beds.

That idea has been met with skepticism from some staff and Hecker acknowledges it’s not an easy task. But she said they believe there’s a way to create efficiencies.

“We’re doing our best to treat the same number of patients and focused on that throughput so we can treat the same number of patients,” Hecker said.

“We have to make tough decisions and we’re doing it as thoughtfully as we can and are working to care for as many psychiatric patients as we can within our system,” she said.

Hecker also noted that UW Medicine is working to build a 150-bed Behavioral Health Teaching Facility on the Northwest campus. That project has not yet broken ground, but received state money to begin planning.

Hecker said it would be ideal to wait until that building is open to close Seven North, but the current financial strains mean that is not feasible.

The closure is happening against a backdrop of growing mental health needs in the community.

Covid-19 and ongoing outrage over systemic racism and police violence against Black people mean more people are experiencing mental health issues, according to Jeremiah Bainbridge with the Seattle branch of the National Alliance on Mental Illness.

“We’re hitting a huge mental health crisis point that’s been building for years,” Bainbridge said.

He said this is not a good time to see cuts in services but it’s often the case when there’s financial strain.