Crozer Health is planning on shutting down mental health services. Delco patients are scrambling.

When police found Ryan Smith in the midst of a manic episode outside his Darby Township apartment in February, they took him to the crisis center at Crozer-Chester Medical Center. There, Smith, a 38-year-old writer diagnosed with bipolar disorder about two decades ago, was evaluated and prepared for hospitalization.

But Crozer’s for-profit owner, Prospect Medical Holdings Inc., is currently planning on shutting down the crisis center along with most of the system’s mental and behavioral health services.

“I’m not sure where they would send us to when we’re having a crisis,” said Smith, who was transferred to Belmont Behavioral Hospital, where he stayed for about two weeks.

Crozer Health, a four-hospital system in Delaware County, has struggled for years. In October, Prospect Medical Holdings put up for-sale signs on the properties. Since then, Crozer has announced service cuts and layoffs.

» READ MORE: Crozer’s Delaware County Memorial Hospital will lose more services by the end of May

Last month, WHYY reported that Crozer is planning on shutting down most of its mental and behavioral health units in June. Delaware County Memorial Hospital in Drexel Hill will lose its outpatient substance-use clinic June 10. Crozer-Chester will close its inpatient substance-use unit June 11, and its crisis center along with all mental health and substance-use disorder outpatient services at Community Campus June 19.

Despite the announcement, Kevin Spiegel, Chief Executive Officer of Crozer, is hopeful that the services could remain open — provided the county increases its reimbursement to the system for them.

Crozer and Delaware County leadership will meet next Tuesday. According to Delaware County Council Chair, Monica Taylor, there are still unanswered questions about Crozer’s finances that she hopes to get answered in that meeting.

But already some units have been closed for months and patients have been told to look for care elsewhere.

Crozer employees, elected officials, and patients worry that if Crozer continues with the planned closure of these services, people seeking mental or behavioral health treatment in Delaware County will be left with even fewer options at a time when many people are struggling with pandemic-related issues.

Peggy Malone, the president of the Crozer-Chester Nurses Association and a nurse in the psychiatric inpatient unit, predicts overworked emergency departments and patients will suffer. “Our emergency rooms already have less staff on every shift,” Malone says, “and now we’re going to tax that system by putting our mentally ill crisis patients in there who need special observation. It’s extremely unsafe for these patients.”

Malone has worked at Crozer for 33 years and has spent the last five years at the inpatient substance-use disorder unit at Crozer-Chester. She says the unit has been closed since December and she was recently reassigned to an inpatient unit that is among the few mental health services that Crozer isn’t shutting down.

The closures, Malone says, will have an impact on the ability of providers to ensure follow-up and continued care. “A lot of our psychiatrist patients go through our outpatient clinics, and they get their medications and therapy and see their counselors through that. They’re taking away all those services,” she says. “All we are going to have is a unit where to put them in for immediate care.” After their release, they’ll have to find other care.

Rachel Rubinstein, a 32-year-old insurance representative from Brookhaven, has been struggling with depression, agoraphobia, and severe panic attacks since childhood. From 2018, she has been going to weekly therapy and visits a psychiatrist every other month for medication management at the outpatient clinics of Crozer in Chester.

On April 25, Rubinstein says, she was attending her weekly therapy session virtually when her therapist broke the news to her that the practice will close June 19. “My first thought was ‘Oh my goodness, what am I going to do?’” Rubinstein recalls

In addition to her appointments in the outpatient clinics, Rubinstein visited the crisis center in the past and has called during panic attacks when she was alone and felt unsafe. “The people there who answer the phone, the social workers, actually do a great job at talking you down.”

For the last two weeks, Rubinstein has been looking for a therapist and a psychiatrist. As a working person on Medicaid, she is struggling even more than someone with private insurance and a flexible schedule would. “Finding a therapist that takes Medicaid has always been a struggle. Finding a therapist that takes Medicaid that can accommodate someone who works is even harder,” she says.

The loss of Crozer’s services comes at a time when demand for behavioral and mental health services has outpaced supply in the region. In the Philadelphia area, a preexisting mental health backlog has been exacerbated by increased demand due to the stressors of the pandemic.

» READ MORE: The Philly region has few beds for behavioral health patients — and intense demand

It also comes at a time of turmoil for regional health facilities and their patients. Just in the last few months, two Tower Health hospitals in Chester County have closed, and the U.S. Department of Veterans Affairs is proposing to close two hospitals in Coatesville and University City.

In April, the Delaware County Council passed an ordinance requiring Prospect to give 180 days’ notice before services are shut down. Taylor, chair of the council, says that in the past nonprofit hospitals worked with the county on transitioning services. Prospect has “just cut programs and are not working in any way to transition these individuals into other programs or support them through that transition,” she says.

In addition to the conversations with Crozer, the county has been working with other providers to expand existing programs and set up new ones as an alternative to those that Crozer is shutting down. Taylor is also waiting to hear if the reported negotiation between Prospect Medical Holdings and ChristianaCare, Delaware’s largest health-care system, may lead to a sale.

It’s unclear whether any of these alternatives will be ready in time to ensure that care for current Crozer patients isn’t interrupted if a resolution isn’t reached.

A few months after his manic episode, Smith says that he is doing better. He believes he is on the right regimen of medications, but finding the support he needs is a struggle. “It’s hard to get good help if you are mentally ill in Delaware County.”