The multi-year plan will put psychiatric and substance-use care within easy reach for residents in West and Southwest Philadelphia, at a time when both mental illness and drug and alcohol dependence are surging in the city.

The project will begin with moving inpatient psychiatric and drug and alcohol detoxification units from Penn Presbyterian Medical Center to HUP Cedar in July. This will be followed later in the summer by the opening of a new crisis response centre, which is expected to provide an estimated 4000 patient visits each year. The move will create two fully integrated mental health hubs at Penn Medicine facilities in Philadelphia, offering emergency mental health services and inpatient and outpatient care at both HUP Cedar and Pennsylvania Hospital, which has operated a CRC since 1999.

Together, Pennsylvania Hospital and HUP Cedar will have 73 licensed inpatient psychiatric beds and 16 beds for substance-use treatment. Additional space at HUP Cedar will allow for expansion of co-ordinated services to further care for communities over the next five years.

“The Covid-19 pandemic accelerated the mental health crisis across the nation,” said Kevin B. Mahoney, chief executive of the University of Pennsylvania Health System (UPHS). As Covid recedes, we have a moral imperative to tackle this suffering in our communities.

“Providing easy access to care when people are in crisis changes – and saves – lives. We’re committed to the investment and innovation needed to close the gaps in access to care and reverse the toll of mental health and substance use in Philadelphia.”

Microcosm of the national picture

As one of the nation’s largest cities, Philadelphia’s mental health struggles are a microcosm of broader trends: a Pew Research Center survey from late 2022 reported that 41 per cent of Americans – and nearly 60 per cent of young adults – have experienced high levels of psychological distress at least once since the early stages of the pandemic. At the same time, more than two-thirds of Americans live in areas without sufficient psychiatrists and other mental health professionals. In Philadelphia, more than 20 per cent of the city’s residents are coping with a diagnosed depressive disorder and substance use-related deaths have climbed to record levels.

Similar to the CRC at Pennsylvania Hospital, the HUP Cedar CRC — which will replace the CRC previously operated on the site by Mercy Philadelphia Hospital until its closure in March 2020 — will be licensed as a crisis intervention walk-in facility and will serve as a discreet psychiatric emergency room. It will provide triage, evaluation, treatment, and social services support for acute substance use and serious psychiatric conditions, such as bipolar disorder, major depression, anxiety disorders, and schizophrenia.

Co-location of the inpatient psychiatric units with emergency care provided through the CRC will enable a seamless transition of care for patients, eliminating the wait time and additional steps required to transfer patients to inpatient units at other facilities – a common occurrence in a city where emergency psychiatric resources remain in short supply.

“We know that a lack of quality mental health support and crisis response services has a traumatic ripple effect across families and entire communities,” said UPHS chief operating officer Michele Volpe. “When patients and families are coping with a mental health crisis, the last thing they need to think about is how to navigate a complex system.

“By putting all our services together, we can help keep patients safer, get them into treatment faster, and better support families as they begin to navigate supporting their loved ones during their hospitalisation and recovery.”

Staff at both CRC locations will be connected via a real-time data system, providing details on bed availability to help place patients as quickly as possible and ensure each location has suitable staffing resources. Penn Presbyterian will continue to provide select outpatient psychiatric care as well treatment for substance-use disorders after the transition of inpatient services to HUP Cedar.

Penn Medicine will invest $5.76m towards the opening of the CRC at HUP Cedar, as part of the mental health hub project. The CRC reopening has also received funding from the Independence Blue Cross Foundation, and the City of Philadelphia Department of Behavioral Health earmarked $4.1 million in reinvestment funds through HealthChoices.

Paediatric care

In addition to Penn Medicine’s adult mental health services, Children’s Hospital of Philadelphia plans to open an inpatient paediatric behavioural health facility, the CHOP Behavioral Health & Crisis Center, on the site, too. This 46-bed acute inpatient psychiatric facility and 24/7 walk-in crisis centre aims to create a safe, inclusive and restorative setting for children and adolescents.

The second phase of the new mental health hub plan will also increase care capacity at Penn Presbyterian Medical Center (PPMC), by converting vacated psychiatric beds to medical surgical units. This should help improve patient movement across the hospital, reducing emergency department wait times, and providing additional capacity for post-surgery recovery.

This summer, Penn Medicine will add a new path for training fellows in drug and alcohol-use treatment. That programme, for physicians specialising in family medicine, primary care, and emergency medicine, among other disciplines, aims to ensure that providers in multiple settings are equipped to help patients take steps towards recovery and adds to the existing fellowship in Addiction Psychiatry at Penn Medicine and the Corporal Michael J. Crescenz Veterans Affairs Medical Center in Philadelphia.

In addition, a new consultation service provides psychiatric care for patients hospitalised for complex medical needs at the Hospital of the University of Pennsylvania, Pennsylvania Hospital, and Penn Presbyterian Medical Center. A new medical-psychiatric unit is also planned to ensure that patients with these complex needs are cared for in dedicated spaces.

“Expanding our resources to care for mental health needs in Philadelphia is a core part of our mission,” said Regina Cunningham, PhD, RN, chief executive of the Hospital of the University of Pennsylvania. “No matter where people live in the city, we aspire to provide them with support in convenient settings, and work to erase both the stigmas and access problems that stand in the way of helping people get help.”