The demand for behavioral and mental health services for adults and adolescents spiked during the COVID-19 pandemic and continued to rise in subsequent years throughout our communities. HCA Healthcare responded by investing in numerous in-house services, community outreach programs and facilities, and by establishing key partnerships with local organizations.

“HCA Healthcare is committed to the belief that mental health is just as important as physical health,” says Eric Paul, president of HCA Healthcare Behavioral Health Services. “Mental health is health. Behavioral Health Services has grown to become the third-largest provider of mental health services in the nation, with over 110,000 inpatient admissions annually.”

Supported by more than 4,300 Behavioral Health Services colleagues in 16 states, HCA Healthcare operates 58 facilities across the country. Additionally, HCA Healthcare is one of the nation’s largest employers of psychiatrists, with one of the largest behavioral health Graduate Medical Education residency programs across 14 locations. We are also the nation’s largest provider of neuromodulation procedures (also known as electroconvulsive therapy, or ECT), which help individuals suffering from severe mental illnesses that are treatment resistant.

There is now a growing attention to and awareness of serving adolescents with mental health needs. More than 1 in 5 adolescents are currently experiencing, or have experienced at some point in their lives, a debilitating mental illness. Just last year, HCA Healthcare emergency departments saw more than 25,000 adolescents between the ages of 12 and 17 who had a primary mental health diagnosis. Additionally, suicide is now the second leading cause of death for people ages 12 to 18, according to the Centers for Disease Control and Prevention. Each day, there are an average of 3,703 suicide attempts by young people in grades 9 through 12. If that average included grades 7 and 8, the number would be even higher.

“Mental illness does not discriminate. It affects people of all socioeconomic backgrounds, education levels, genders, ages, races and ethnicities,” says Amy Rushton, DNP, APRN-BC, chief nursing executive and vice president, Behavioral Health Services. “Our individual facilities provide various inpatient and/or outpatient programs, including those for older adults, adults, adolescents and children struggling with depression, anxiety, post-traumatic stress disorder, eating disorders, substance abuse and mood disorders.”

In Chattanooga, Tennessee, HCA Healthcare’s Parkridge Valley Child and Adolescent Campus treats children and adolescents with emotional and mental health conditions ranging from anxiety, depression, obsessive-compulsive disorder, attention-deficit/hyperactivity disorder and mood disorders to disorders associated with abuse and other traumas. On the 87-acre campus is a very special school — Valley Academy.

“It’s about doing what is best for these kids and giving them the best opportunity to succeed,” says Hallie Bailey, Parkridge Valley’s director of Nursing. “It’s amazing that these vulnerable kids come in low-functioning and leave on-track and happy. Some kids can’t even read when they start, and they just end up blossoming.”

Valley Academy colleagues are helping students obtain their GEDs and apply to colleges. Some graduates have gone on to become nurses, and one student even returned to work at the school. The staff and faculty are not only an educational resource, but they are also bringing the kind of compassionate care to their work that matters at HCA Healthcare.

In one instance, a student graduating from Valley Academy had no family present. The entire Parkridge Valley team attended the ceremony to hum “Pomp and Circumstance” and watch her receive her diploma. That graduate is now a practicing therapist.

“During their time at Valley Academy, we help change our students’ perspectives and attitudes toward school for the better,” says Hallie.

Valley Academy consists of an elementary school and a high school, and follows a 12-month schedule, with classes from 8 a.m. to 4 p.m., Monday through Friday. Students are children and adolescents in the residential treatment program at Parkridge Valley, where the average stay is six months. State licensed as a special purpose school, Valley Academy follows the county’s core curriculum and includes language arts, math, science and social studies.

Staff members are employees of Parkridge Valley, and the principal holds a master’s degree and certification in special education. The academy also has an educational liaison and a certified school psychologist. Students have access to iPads, a library, a kitchen where they can learn to cook, a garden for growing vegetables and a gym for recreation.

Physical activities are incorporated with school lessons and therapy, resulting in a true team approach.

“Teachers here are working year-round,” says Farlie Chastain, Parkridge Valley’s director of Social Services. “They do it because they want to see these kids thrive long-term.”

HCA Healthcare Behavioral Health Services, along with the
HCA Healthcare Foundation, has partnered with several organizations to raise awareness and to support mental health needs for youth. This includes:

• The Girl Scouts Mental Wellness patch program, with iterations for Junior, Cadette and Senior/Ambassador age groups, launched at the Girl Scout Convention last summer and is now available to all troops nationwide.  The programs – Knowing My Emotions, Finding My Voice, and Showing Up for Me and You – encourage girls to learn about mental wellness for themselves and others, recognize and understand their feelings, effectively cope with mental health challenges, and feel comfortable seeking help. Through the mental wellness patch program, over 16,000 patches have been earned to date.
• The Jason Foundation is a nonprofit dedicated to the prevention of youth suicide through educational and awareness programs. The programs equip young people, educators, youth workers and parents with tools and resources to help identify and assist at-risk youth.

In 2020 HCA Healthcare formed a partnership with EVERFI from Blackbaud, an international technology company driving social change through education, to implement an interactive mental health and wellness digital education course for middle school and high school students.

With HCA Healthcare’s support, EVERFI’s Understanding Mental Wellness course has reached more than 245,000 students and roughly 3,600 teachers at more than 1,600 schools. In 2023, there were three in-person events with schools focused on mental health and wellness. An event held earlier this year at Hastings High School in Houston, Texas, drew almost 150 students.

“Deepening HCA Healthcare’s commitment to championing positive mental wellness, we’re proud of this strategic partnership to provide the Understanding Mental Wellness course to middle and high school students across all of HCA Healthcare’s 15 U.S. divisions,” says Eric Paul, President, HCA Healthcare’s Behavioral Health Services. “The program aims to help educators foster mental well-being in their classrooms and equip students with lifelong mental wellness skills.”

“It was such an honor and a privilege to listen to the break-out sessions that the students were having with their leaders,” says Kim Williams, Assistant Vice President of Community Engagement, HCA Healthcare Gulf Coast. “Everyone leaned in and was engaged. And to be leaned in and engaged at 9 a.m., talking about mental wellness and social media and taking care of ourselves is a very big accomplishment.”

Event topics ranged from navigating social media and mental health challenges, suicide prevention awareness, and fostering a supportive environment. Most importantly, it identified available resources, including school counselors, which students could access to deal with these issues.

An additional complexity in the mental health space is the reality that 11% of adults experiencing mental illness are without adequate insurance coverage and access to proper care. Nearly half of people living in the United States live in what are called Mental Health Professional Shortage Areas.

“Most of the communities we serve do not have enough behavioral health beds or space to treat growing numbers of adults and adolescents,” says Amy Rushton, DNP, APRN-BC, chief nursing executive and vice president, Behavioral Health Services.

To better support more residents in more communities, HCA Healthcare has expanded existing facilities and opened new ones.

Expansions and openings

• Opened Live Oak Mental Health & Wellness in South Carolina and Sweeten Creek Mental Health & Wellness Center in North Carolina, adding more than 180 inpatient beds (combined) in 2023.
• Acquired Haven Behavioral Hospital (now Medical City Mental Health & Wellness Center) in Frisco, Texas, in March, with plans to open Medical City Mental Health & Wellness Center Alliance in Fort Worth, Texas, this winter, adding more than 150 inpatient beds (combined).
• Opening several mental health and wellness therapy centers that offer in-person and virtual individual and group therapy options.
• Increased offerings like intensive outpatient programs (IOPs) with group therapy and partial hospitalization programs (PHPs) for adults and adolescents struggling with conditions like depression, anxiety, eating disorders, addictions and trauma.
• Graduate Medical Education residency programs and Galen College of Nursing cultivate interest in behavioral health and increase the number of psychiatrists and clinicians in our facilities.
• Partnered with Galen College of Nursing to offer opportunities for clinical rotations and placement in HCA Healthcare behavioral health facilities.

HCA Healthcare’s service lines continue to focus on staffing and leadership development, with an emphasis on colleague recruitment and retention. One approach to retaining nursing and therapy colleagues is through a clinical supervision pilot taking place at several behavioral health hospitals. The model will provide high-quality clinical supervision to masters-level associates in return for two years of employment following full clinical licensure.

Behavioral Health Services launched its Research Council this year to conduct clinical trials and research. HCA Healthcare is in a prime position to support the council with its growing Health Research Institute, vast data repository (which includes more than 120,000 behavioral health inpatient admissions) and access to acute care facilities.

The goal is to create a pipeline for promoting excellence in mental health care, develop insights and deliver outcomes through research-led initiatives.

“This will allow us to contribute to clinical and operational practices that elevate patient care,” says Eric Paul, President, HCA Healthcare’s Behavioral Health Services.

Medical City Green Oaks Hospital in Dallas, Texas, is engaged in a Phase III clinical trial investigating the potential of Psilocybin to help individuals with treatment-resistant depression (TRD). Psilocybin, the active component found in more than 200 species of psychedelic mushrooms, has garnered attention over the past 25 years for its therapeutic properties when coupled with therapy.

The study will assess the effectiveness of the investigational medication at various dosage levels in conjunction with psychological support. If successful, the Green Oaks trial could signify a breakthrough in addressing the challenges posed by treatment-resistant depression, offering hope to individuals who have not responded to conventional antidepressant therapies.