Nearly two months after the Yale Stress Center closed its doors to patients, members of the Yale community who are ineligible for many of Yale’s on-campus mental health resources are still struggling to find a replacement.
The clinical side of the Stress Center, an interdisciplinary research center that had been run by the Yale Medical Group and department of psychiatry, was shut down because it was running at a significant financial loss each year, said University spokeswoman Karen Peart. The research side of the center is still operative.
The June 30 closure, which was announced just over a month before the planned closing, left patients scrambling to find new providers, according to patients and clinicians interviewed.
“In light of the need to assure that clients have adequate and appropriate referrals, I do think more time could have been given between the announcement and the expectation of when patients would complete their treatment at the clinic,” said Rachel Hart, a counselor at the Stress Center, in a June email. She noted that no other clinic in New Haven offers an integrative treatment model for stress, making it even more difficult for patients to find a comparable replacement.
But John Krystal, chair of the Psychiatry Department and chief of psychiatry at Yale-New Haven Hospital, said most of the clinic’s treatment programs were short-term. A one-month notice gave patients sufficient time to finish their treatment regimens, he said.
Rajita Sinha, the center’s director, said the center had enough time to give every patient an individualized discharge plan. Though she noted the closure came as somewhat of a surprise, she said the clinic’s contract was reviewed on an annual basis and management was aware that its economic model might not last.
The center, which opened in 2007 and launched a clinical side in 2012, employed 15 clinicians, who provided treatment to Yale employees as well as New Haven residents. Yale’s health plans cover some but not all staff members, so many employees need to search elsewhere for care.
According to Krystal, the clinic was expensive to operate because, in addition to traditional treatment methods, it offered relaxation, breathing training, acupuncture and other unconventional methods, which are reimbursed at a lower rate.
Peart said the Yale Medical Group is exploring other ways to offer some elements of the clinic. Still, for some, the steps Yale took during that month were not enough.
A research assistant at the medical school who asked to remain anonymous for fear of damaging future job prospects said she has called eight providers since she found out about the closing. Four never responded, and the other four are not accepting new patients, have prohibitively long waitlists or are unwilling to continue her medication, she said.
Her options are limited by her insurance — the Stress Center was one of the few providers in the area that accepted Magellan, Yale’s employee insurance — and her diagnosis of adult attention deficit disorder.
To tide her over while she searched, the research assistant said, her Stress Center therapist wrote her a three-month prescription before the center’s closing. That prescription will expire in a month.
“If I don’t hear back from someone soon, I have to decide if I want to pay out of pocket or try to rough it without my medication until I can get an appointment with someone,” she said.
The abrupt ending has also negatively affected some of the clinic’s employees.
Mary Savoye, a dietician at the clinic, said the loss of income from the center removed 10 percent of her paycheck; the rest of her income comes from other sources. She had to quickly find another nutrition services clinic to make up for the loss before the center’s closure.
She said other clinicians have mentioned now needing to set up their own practices.
Sinha said that despite the short notice, all the clinic staff members who left have found employment in the Yale system or elsewhere. She noted that while it is especially difficult for patients being treated for mental health issues to switch therapists, some of the Stress Center’s patients have been able to follow their provider into private practice and maintain their services.
“We can’t determine all the other factors that go into closures,” Sinha said. “But from a clinical perspective, we did everything possible to connect patients to the best available care.”
The center has not conducted an exit survey, so the exact number of patients who have found other treatment options is unknown, Sinha said.
Though all former staff members have found new employment, private practices — where some of them are now — do not allow for the same level of experimentation as the center’s clinic did.
“[The center] has been a home for clinicians like myself who take an integrative approach to health care,” said Anne Dutton, another clinician. “It was unique in that we provided cutting edge, evidence-based clinical services that cannot be found elsewhere at Yale.”
Krystal hopes future circumstances will allow the University to reintroduce the strengths of the clinic in a more economically sustainable manner.
“We are very proud of what the Clinic was able to achieve. But we have learned that we have to do it in a different way,” he said. “I suspect it will take us some time to figure this out.”