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About Mental Health

Measures to stem self-harm in San Mateo Medical Center’s psych unit.

In an effort to reduce the risk of suicide in the San Mateo Medical Center’s psychiatry unit, health officials in the coming months are joining other hospitals providing psychiatric services to eliminate potential risks in the unit.

Dr. Chester Kunnappilly, CEO of the San Mateo Medical Center, said the county facility is not alone in monitoring standards for identifying and mitigating risks to patients receiving in-patient mental health services, noting those standards are continually being updated as more information on unfortunate events occurring at other institutions is gathered.

In the absence of such events occurring at the San Mateo Medical Center, Kunnappilly said officials have been focused on staying ahead of any potential risks in the hospital facilities where in-patient and emergency psychiatric services are provided. As a national accrediting organization, The Joint Commission conducts a routine survey of the hospital roughly every three years, which in part prompted county health officials to several years ago update the door knobs and other features identified as potential hazards for patients who might consider harming themselves, said Kunnappilly.

During The Joint Commission’s most recent survey in December of 2018, the commission identified potential ligature, or hanging, hazards in the hospital’s psychiatry unit, which holds 34 licensed beds, said Kunnappilly. Well aware that planning and approval of mitigation measures can take months, officials have been focused on planning for changes to the unit’s door knobs, latches and hinges, he said.

“That’s really the focus of this,” he said. “How do we make our facilities as safe as we possibly can for clients who might have a risk to harm themselves?”

Kunnappilly said the hospital has increased staffing in the unit to observe patients and mitigate the risks as the planned updates to the unit await approval by California’s Office of Statewide Health Planning and Development. Once they are in place, the updates are expected to reduce the need to use overtime or temporary help to observe patients, and allow staff to focus more on patient rehabilitation and spend less time on patient observation, he said.

“We are happy that the unit will become even safer,” he said. “We hope that it will give people a little bit more freedom in the unit.”

Slated to take shape in three three-month phases, the work to update the unit will temporarily reduce the number of beds available at the hospital’s psychiatry unit to 17 and require San Mateo County Health’s Behavioral Health & Recovery Services to place clients in other facilities if demand exceeds the available beds, which could cost $795,000 to $1.6 million annually, said Kunnappilly.

He said the facility currently has about 30 of the 34 licensed beds filled, and noted demand at times exceeds the hospital’s capacity to provide psychiatric services. When that happens, Kunnappilly said the hospital works with outside facilities to find other licensed beds, adding a similar process would be undertaken as the construction takes shape, with officials aiming to place patients as close to the San Mateo Medical Center as possible.

Once approval from the California Office of Statewide Health Planning and Development is granted for the changes, Kunnappilly said the work would go out to bid and hopefully be completed in some nine months. He said the hospital is required to do the work before March of 2021, and he is confident they will be able to complete it before then.

Kunnappilly expressed gratitude to The Joint Commission and county officials for their support in implementing a proactive approach in mitigating potential risks and maintaining the highest standards for patient safety.

“I just am proud to work for an organization that is constantly trying to stay ahead of risk,” he said.

If you or someone you know needs help, you can call the Suicide Prevention Lifeline at 1-800-273-8255.