At the Brien Center, we do our best to provide high-quality care for thousands of people in the Berkshires through comprehensive programs and services delivered in community settings. Yet, it is not unusual for our Crisis Team to determine that an individual is facing a life or death situation due to their mental illness or addiction and must be evaluated in the emergency department and possibly hospitalized.

All patients, no matter what their illness or injury, deserve prompt care at their community hospital. If Question 1 is approved, I fear that some of our clients will necessarily be turned away if the hospital — on that particular day — has reached the nurse-patient ratio that will be imposed by this new law. As voters mull over what impact this legislation will have, I’m asking that they consider what will happen to people suffering from severe psychosis, those who are suicidal, or those in desperate need of detox. Sending them or any person elsewhere for care will add a detrimental and very disruptive element to an already terrible situation.

STAFFING RATIOS

Compounding this even further will be the toll on the Brien Center Crisis Team, which already struggles to meet the community’s need for our services. My staff will have to secure in-patient psychiatric or detox placements elsewhere — another daunting challenge since all Massachusetts hospitals will be facing the same rigid staffing ratios as Berkshire Medical Center and Fairview Hospital. Plus, the extra time required to help these individuals and families will take away from others in crisis.

Another potential consequence will be the Brien Center’s continued ability to recruit and retain nurses for vital community-based behavioral health services that require RN certification by our regulators.

Berkshire Health Systems and the Brien Center have a long history of collaboration. In fact, we could not provide our current level of care without BHS help and support. However, the Brien Center already struggles to compete with BHS in a challenging labor market for nurses. If successful, Question 1 will only exacerbate this dynamic. Faced with $25,000 fines for each time the nurse-to-patient ratios are exceeded, hospitals will be forced to take whatever steps necessary to comply with the staffing levels mandated by the ballot question. If Brien loses nurses, our ability to provide quality services in community settings will be significantly more difficult.

DANGEROUS PRECEDENT

And finally, I’m very concerned that Question 1 will establish a dangerous precedent in which all patient care staffing decisions are determined at the ballot box. First the hospitals, and then what? Agencies like the Brien Center could possibly be next. The blunt use of statewide referendum questions to impose staffing ratios on healthcare will be disastrous for our community.

We are dedicated to the more than 10,000 courageous Berkshire County individuals and families who receive services from the Brien Center every year. If approved, Question 1 will make their recoveries more challenging by impacting the care they deserve. Please vote “No.”

M. Christine Macbeth is president and CEO of the Brien Center.

Read the op-ed at the Berkshire Eagle »