Technology bridges distance
for NMMC patients
FORT KENT — As psychiatric services across Maine are scaled back or eliminated altogether, the demand for inpatient and outpatient care at Northern Maine Medical Center (NMMC) is growing, and patients are coming from further away.
The Fort Kent hospital is the only facility to offer voluntary admission, in-patient psychiatric care north of Bangor. NMMC is one of only seven hospitals in Maine to offer adult in-patient psychiatric services, and one of only three in Maine with a specially designated unit for children and adolescents.
“A good number of services in Maine have been eliminated because the overwhelming number of patients utilizing them are MaineCare or Medicare patients and the reimbursement is just not there to make it financially feasible,” said Dr. Mark Overton, NMMC psychiatrist. “As a result, we are seeing a greater demand for our services, both in-patient and out-patient. We are also having a greater number of patients referred to us from downstate when the units there are full.”
NMMC has specially trained mental health staff that work in both their seven-bed adult unit and seven-bed child/adolescent unit. The patient volume for the adult unit averages about 70 percent from Aroostook County and 30 percent from outside northern Maine. On the child/adolescent unit, upwards of 40 percent of inpatients come from south of Millinocket.
With the growing number of patients from away comes challenge, according to Jane Rioux, RN, who manages both the adult and child/adolescent units at NMMC. Individuals from a significant distance in need of the services were frequently hesitant about being so far from family when being treated. It was also a concern for the medical professionals at both NMMC and the sending hospital who often see the interaction with family as a necessary component in working with patients and for their overall wellbeing.
“Patients generally say they like our unit because it is small and they get a lot of attention from staff. So, we needed to figure out a way to extend that personalized care to the patients from away when it came to their ability to interact with family,” said Rioux.
To bridge the distance, the psychiatric team at NMMC developed an innovative and cost-effective solution — use Skype to connect patients with their loved ones back home. For the past several months, a growing number of patients from southern Maine have been connecting with family at a distance, both in treatment sessions and just to keep in contact.
“Our job is to make sure that our patients are in a safe environment in all aspects — safe in terms of physical environment, privacy and of course emotional environment,” said Rioux. “We see the ability to connect patients with family, their support system, through technology as a key component in our efforts to foster hope, strength and self-determination to help them get well.”
In the future, Rioux and her team are looking to expand the use of technology, especially in the child/adolescent unit, where the patients need to keep up with their schoolwork. She hopes to establish ties with the schools where each patient is enrolled to have a tutor connect via Skype to provide instruction so the student continues with their academic progress while being treated.
In addition to seeing more patients from away, NMMC has also seen a greater demand in recent months for psychiatric services locally, especially for the adolescent population. The scaling back of outpatient services in the County, coupled with the closing of both a group home operated by Aroostook Mental Health Services in Grand Isle and the Christopher Home in Caribou, have more families turning to NMMC.
The economic downturn has been a driving factor in the adult patient increase. Rioux has seen a spike in the number of homeless patients in the adult unit. The NMMC team takes great pride in the fact that they ensure when patients are discharged they always have a safe place to go.
“It’s a great challenge, but one that we take on,” said Rioux.
A larger number of homeless patients is not the only trend that economic conditions have created. The impact has extended beyond just the psychiatric units at NMMC.
“Patients may go without medication or services they need and end up in the emergency department and we are challenged with finding a place for them. There are times when our psychiatric unit is full of patients who were voluntarily admitted and we need to try and find a place for them downstate. There are a lot fewer involuntary beds than there used to be in Maine,” added Rioux.
The in-patient psychiatric services at NMMC are led by a board-certified psychiatrist and highly-trained nursing staff who assess, plan, direct and oversee delivery of care and provide therapeutic groups throughout the day. Additionally, NMMC social workers and an occupational therapist work on the team to help patients with life skills and help them function optimally.
Aside from NMMC, the only other hospitals in Maine to provide voluntary admission, child/adolescent and adult inpatient psychiatric are Acadia Hospital in Bangor and Spring Harbor Hospital in Portland.
