Future Uncertain

By Catherine Shu

When Governor George Pataki included plans to close the Bronx Psychiatric Center in his late January budget proposal, the anxiety felt by many of the center's 420 patients and their families was compounded by a lack of alternatives. Not only is the Bronx Psychiatric Center the borough's one long-term state psychiatric center, but it also houses the only Spanish-speaking bilingual wards in the entire state system.

For many advocates, the governor's decision to target the Bronx Psychiatric Center underscored his failure to take the neighboring community's needs into account. Half of the Bronx's population is Hispanic, many of whom are recent immigrants "with a very rudimentary command of the English language," said Carlos Rodriguez, a therapist on one of the bilingual wards.

Patients were granted a reprieve in late May when Pataki’s proposal was blocked by the state legislature. But the initial panic has only been replaced by a constant anxiety that the closing can be revived at any time, and families continue to worry about what might happen to their loved ones.

Rodriguez pointed out that the unique services offered in the bilingual wards goes beyond language assistance. The staff is also trained to take cultural factors into account when treating inpatients of Hispanic descent.

"I'm not aware of other units that are aggressively incorporating concepts of multicultural psychiatry," Rodriguez said, "While I’m sure that there are Hispanic personnel elsewhere, I'm not sure that an environment like this has been created."

Many of the patients on the bilingual wards are recent immigrants to the United States and the staff is trained to take those experiences into account when evaluating a patient's ability to function.

"There are issues of whether we need to assist the client in the process of acculturation or immigration," Rodriguez said, "A patient's diagnosis may be revised because some of the issues present may be more related to those factors than to psychiatric or psychotic syndromes."

Therapists and psychiatrists on the wards also "incorporate cultural elements that need to be addressed" in a treatment plan, Rodriguez said, "like religious ideas or spiritual beliefs that the client may have."

While Rodriguez credits the multicultural and bilingual approach to psychiatry with shorter stays for long-term patients, he also stressed the need for long-term treatment required by many psychiatric disorders. Other advocates have also voiced these concerns, noting that the center's inpatient census is at a maximum and that many outpatients also depend on the center's therapists and programs for monitoring and care.

“There will be no venue for doctors and therapists to either reach their clients or keep in touch,” said Paulina Magnetti, the director of the Bronx Provider Consumer Alliance Resource Center.

Rodriguez worries that former inpatients who successfully took advantage of the services offered in the bilingual wards will not have access to the same treatment plans if they should suffer a relapse.

"Rehospitalization is part of the a chronic illness and the thing is, will there be services available for these patients, so as to shorten their stays?" he asked.

In addition to their Bronx clientele, the bilingual wards also serves patients from Manhattan and Brooklyn.

“The day we discharge someone, someone comes in. We never have empty beds waiting,” said Rodriguez, “I think it’s incredible when you think of the demand and the need for longer term psychiatric care that is in this community.”

While no plans have been made concrete, many families and staff believe that patients will be transferred to Pilgrim Psychiatric Center on Long Island if the BPC does close. While Pilgrim also offers language services to Hispanic patients, however, it does not have the same multicultural treatment plans available.

Pilgrim's location also poses a problem for many families.

When the closing was first proposed last January, June Rodriques, a volunteer at the hospital with a sister in one of the inpatient wards, took a "test trip" to Long Island.

"I decided to see how inconvenient or how easy it would be to go to Long Island," Rodriques said, "I went by bus, subway, train, and taxi, and it took me four hours."

Rodriques said that patients depend on their families "to keep them somewhat in touch with the outside world." While she currently visits her sister at least three times a week, Rodriques estimates that she would only be able to make the trip out to Long Island once a month. Many of the lower income families served by the BPC cannot afford private transportation.
Being relocated away from families could be especially detrimental to patients on the bilingual wards because "Hispanic families tend to stay very close," Carlos Rodriguez said.

"I think one of the reasons that [the bilingual] units had been opened here was because some of these patients had been sent to hospitals far away from their families in the Bronx," Carlos Rodriguez said, "Some people come here so that they can be closer to their families, so that we can integrate their family into the treatment."

Though Governor Pataki's initial proposals (which also included plans to close three upstate psychiatric centers) was blocked by the state legislature in late May, the future of the Bronx Psychiatric Center and its sister institute, the Bronx Children's Psychiatric Center, continues to hinge on the precarious health of the economy.

“If they should close this hospital, who is going to serve the population of the Bronx, particularly the Hispanic population?” asked Rodriguez.

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