New psych hospitals tap new market — insured heroin addicts

WBUR’s piece on private treatment centers for insured heroin addicts harkens back to  the ‘80s, when  private psychiatric hospitals popped up to treat troubled adolescents. Teenage angst was medicalized for the insured and  when 30 days were up, the kids were out the door. Often, not a lot of healing happened. From a 1990 LA Times story:

Mental health professionals have welcomed expanded psychiatric care for a segment of the population long overlooked: seriously disturbed or drug-dependent children under 18. But many worry that the pendulum has now swung too far.

“It’s the proliferation and commercialization of psychiatry,” said Dr. W. Robert Beavers, director of the Southwest Family Institute in Dallas. “We now have something nobody ever heard of 20 years ago–marketing people.”

Beavers, a family psychiatrist for more than three decades, said he has watched with some alarm as the number of children under 18 admitted for inpatient psychiatric treatment increased from about 77,000 in 1970 to about 112,000 in 1986, the last year for which complete statistics were available.

WBUR’s piece on addiction  programs for the insured raises some of the same troubling issues. Start with this quote from Brad Greenstein, CEO of Recovery Centers of America:

Capture1The facility will provide both inpatient and outpatient care, and Greenstein says it will feel almost like a boutique hotel — with well-appointed bedrooms, private therapy rooms, coffee shops and cyber cafes. Although he says eventually RCA plans to build other facilities that will accept those with public insurance, this center in Danvers will only accept commercially insured patients or those who pay out of pocket. These are people, Greenstein says, who are now underserved.

“For people who lack resources, there are a lot of programs that are funded to work with that population, and on the opposite extreme are people who have tremendous resources [who] can go really anywhere they want,” Greenstein said. “What we found, not just in Massachusetts but nationwide, is this lack of availability for your average everyday individual who has been dutifully paying insurance premiums — those are the ones having a hard time accessing care.”

Which takes us to today’s story in the Globe

The Department of Justice is investigating five hospitals run by the largest private provider of mental health services in Massachusetts for possible billing fraud, according to a report filed recently with the Securities and Exchange Commission

In Massachusetts, Arbour has been cited repeatedly by state regulators over poor care and inadequate staffing at its hospitals and outpatient clinics. At Arbour-HRI two years ago, public health officials found the hospital failed to provide active treatment to some patients, whose diagnoses included bipolar disorder and paranoid schizophrenia. Instead of attending group Capture3therapy, inspectors said, patients spent many hours sleeping or wandering the hallways — an allegation the company disputed.

This spring, the US Supreme Court plans to review a case brought by the parents of a deceased Massachusetts teenager against Universal Health Services. Yarushka Rivera died soon after receiving care at an Arbour clinic in Lawrence. Her parents contend that the company defrauded government insurance programs by charging for services provided by therapists unqualified to care for their daughter, who was covered by Medicaid.

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