Healey Administration Pausing Plans To Close Pocasset Mental Health Center

Governor Maura Healey announced Monday evening that she will be pausing her administration's plans to close two mental health centers, including the Pocasset Mental Health Center in Bourne, following strong feedback across the state including some from leaders of Nantucket's Behavioral Health Agencies that opposed the move and said it would be a devastating blow to the efficacy of mental health services within the Commonwealth.

“Over the past few weeks, I have heard directly from patients, families and staff about the important role that Pappas Rehabilitation Hospital for Children and Pocasset Mental Health Center play in their communities,” Healey said. “I’m deeply grateful for their feedback, as well as for the hard work of our teams at the Department of Public Health and Department of Mental Health, who are focused on ensuring that all patients receive the high-quality, modernized, specialized care they need and deserve. At this time, I’ve directed them to pause their plans to close Pappas and Pocasset so that we can bring together a diverse group of stakeholders – including patients, families, labor, local officials, and medical professionals – to conduct a further review of the care offered at these facilities and make recommendations on the best path forward to ensure we are providing the highest quality of care with the resources at hand.”

State senator Dylan Fernandes, formerly the state representative of the Barnstable, Dukes, and Nantucket District, said in a statement late Monday evening that he is deeply grateful for Healey's decision.

“I am deeply grateful to Governor Healey for supporting mental health beds in our region and working to keep the Pocasset location open," Fernandes said. "We spoke out and rallied against the Department of Mental Health’s decision to close the in-patient center and we are incredibly fortunate to have a Governor who listens and deeply cares about the closure’s impact to our geographically isolated region and to people struggling with lack of access to care. We are going to keep fighting for healthcare access on the Cape & South Shore and I want to thank everyone who stood alongside us - especially the Pocasset mental health workers and patients who understand what these beds mean to our district more than anyone.”

The decision is a pivot from Healey’s announcement in late January when her administration said they planned to close the 16-bed psychiatric hospital on Cape Cod and cut the number of Department of Mental Health case managers from 340 to 170.

While Nantucket only had seven patients utilize Pocasset Mental Health Center in 2024, the decision to close Pocasset was met with plenty of opposition from Fairwinds executive director Roberto Santamaria and Community Solutions for Behavioral Health (CSBH) executive director Rosemary McLaughlin.

"The governor’s decision to close the Pocasset Mental Health Center and to reduce the case manager workforce by 50 percent is a devastating blow to the efficacy of mental health services within the Commonwealth," Santamaria said earlier this month. "Behavioral health agencies across the Cape and the Islands depend on these services to provide the best care for their patients. Closing down services located on the Cape further diminishes any behavioral health center’s ability to reach and treat those in need. In light of our extreme national political shifts, now is the time to increase access to mental health services, not hinder them."

"Community Solutions is opposed to the closure of Pocasset Mental Health Center," McLaughlin said earlier this month. "As you're aware, access to inpatient psychiatric beds is very limited, and a closure anywhere can impact the entire system. Pocasset was 90 percent occupied in 2023, the last year data is available. As a state-operated facility, it has flexibility in regards to insurance coverage and length of stay for the patients they serve. Over the past couple of years, few patients have been directly admitted to Pocasset from Nantucket, but for those who need that treatment, it's priceless and maybe not available elsewhere. My understanding is that this closing is not a quality issue, rather an expense issue relating to the limited services, 16 beds versus the physical plant costs. An alternative could be to add services which are needed for Cape Cod and Islands. Behavioral Health treatment for adolescents and elders is difficult to find. Expanding Pocasset's capacity could be more cost-effective."

There is no inpatient psychiatric facility on Nantucket, which leaves clinicians relying on a network of mainland hospitals and mental health centers to send behavioral health patients to when they require inpatient care. These transfers are logistically complex and are made even more challenging by the demand for inpatient beds across the state, as well as the time required to transport patients from Nantucket.

According to the most recent Nantucket Behavioral Health Assessment report published in 2021, mental health patients on Nantucket who need to be transferred to an inpatient psychiatric facility on the mainland typically end up waiting for an available inpatient bed and/or transportation arrangement at the Nantucket Cottage Hospital emergency department or its med/surg unit for one full day up to as many as nine days.

"Nantucket lacks intensive community and/or facility-based stabilization and treatment for individuals in crisis, people escalating toward crisis, and individuals requiring support after a crisis," the report states. "The lack of intensive treatment and support results in people being stabilized in the emergency room and either transferred off-island for inpatient care or returned home without intensive follow-up.

"Further, there is an inadequate system of care for people returning to the island following inpatient or residential treatment that can assist with reintegration. Off-island transport for treatment is expensive, disruptive, and in some cases contributes to more significant conditions than if treatment were available in familiar environments. While NCH has two beds in rooms modified for patient safety, there is a lack of continuity of treatment during the stay in the hospital due to changing physician and nursing coverage. This results in missed opportunities to stabilize individuals on-island.

"Further, hiring 'sitters' to supervise patients and transporting patients off-island is costly and consumes resources that might, in part, be redirected to providing additional treatment to avert and stabilize crisis on the island. Nantucket’s small scale makes it unlikely that higher levels of care such as inpatient and residential treatment will be provided on-island, but there are opportunities to enhance the continuum of care to more often avert, stabilize, and treat individuals closer to home and to bolster supports for people returning to Nantucket after an inpatient or residential stay. While individual organizations are providing pieces of the treatment services needed to prevent crisis, stabilize people after a crisis, and help people returning to the island after an inpatient stay, there is no systematic approach to service delivery."

*Jason Graziadei contributed to this story*