Wheeling, W.Va. Photo by Gage Goulding.

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This is the first of two stories about what happens to small communities when hospitals providing vital mental health services close. Read part two here.

In the summer of 2019, while grieving the sudden deaths of his brother and his closest friend, Joe Hubbard was admitted to Ohio Valley Medical Center in Wheeling. For two years, the 39-year-old had been going to the Hillcrest behavioral health unit at the hospital to get group therapy and be seen by a psychiatrist. He’d stay in the unit overnight, until he felt safe enough to go home.

Hubbard, thin-faced with warm blue eyes and a tight-lipped smile, was a well-known figure around downtown. He often sat by the waterfront listening to music in the company of friends. He was quick to offer a listening ear but he struggled with his own addiction and mental health. 

His first trip to Ohio Valley was in 2017 when an accidental overdose nearly killed him. He said the emergency services saved his life, and he received treatment at the behavioral health center, which was his first step toward long-term recovery.

“The bravest thing I ever did was continue my life when I wanted to die,” Hubbard posted on Facebook. “Journey continues, life is good.”

Joe Hubbard, in an undated photo.
Photo courtesy Colleen Smith.

Hubbard stayed clean for two-and-a-half years, but he struggled with depression and feelings of self-worth. Most of the time he managed his mental health on his own, but when things got particularly difficult and he needed help, he knew where to find it. He’d walk over to the hospital and check himself in. It’s where he went to be safe when he was having thoughts of suicide.  

But now, the hospital was closing. Hubbard was one of the final patients left at the facility as staff began to clear out their things.

Ohio Valley Medical Center served the Wheeling community as a nonprofit medical center for more than 100 years, but the hospital struggled financially and was nearing bankruptcy in 2017. Then, in June of that year, a California-based for-profit company purchased Ohio Valley.

The company, Alecto Healthcare Services, operated another West Virginia hospital in Fairmont and was expanding its presence in the state. 

But two years after purchasing Ohio Valley, in 2019, the company announced plans to close the hospital for good. It cited millions of dollars in financial losses.

Ohio Valley Medical Center in Wheeling, W.Va. Photo by Lauren Peace.

Patients like Hubbard, staff and community leaders worried for the fate of health care in Wheeling. There was another hospital that offered emergency services about 3.5 miles from the city’s center, but Ohio Valley was home to one of the largest providers of inpatient psychiatric services in West Virginia’s Northern Panhandle. 

Employees of the unit worked tirelessly to save their patients’ care, staging protests, and sending letters to Gov. Jim Justice and the West Virginia Department of Health and Human Resources, asking for help. One leader in the medical community, WVU Medicine CEO Albert Wright, offered to take over the behavioral health facility for a year so that patients could continue to receive treatment while the community worked to find a more permanent solution. Alecto said no.

And so that left it to Hubbard and two other remaining patients in the behavioral health unit to band together and plead their case. They wrote notes and asked a staff member to share them on Facebook.

“This place helps us stay alive,” Hubbard wrote in slanted pencil, three weeks before the shutdown.

It didn’t help. The hospital closed. A year later, Hubbard was dead.

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Scott Pelley remembers his friend, Joe Hubbard.

Local media blasted the news with headlines like “Wheeling Police search Ohio River for man who jumped from Suspension Bridge.” Police, friends and family confirmed to Mountain State Spotlight that the man was Hubbard, and his death was reported to them as a suicide. A final ruling from the state Medical Examiner is still pending.

The Governor’s Office did not respond to multiple requests for interviews about Ohio Valley’s closure. Allison Adler, a DHHR spokeswoman, wrote in an email that Justice and her agency reviewed potential actions that might have prevented the loss of care, but officials didn’t find a solution. Adler wrote that the department was “disheartened” by the hospital’s closure.

But to the patients and employees impacted, “disheartened” wasn’t enough.

Martha Connors. Photo by Lauren Peace.

“We asked for help. There were options there, but no one in power did a damn thing,” said Martha Connors, who was a mental health technician in the Hillcrest behavioral health unit for 13 years and started the Facebook page “Save Hillcrest/OVMC/EORH” to help people organize and stay informed prior to the closure.

“More than 700 people lost their jobs and thousands of patients suffered the consequences,” Connors said.

Lost jobs and lost care

It’s not illegal to close a hospital. There are some rules and regulations to protect employees. But there are very few safeguards which assert a continued obligation to patients.

“Health care in the United States is a human and community need, but it’s also a business,” said Carmel Shachar, director of the health law policy center at Harvard Law School. “It’s an area where our ethical and legal senses diverge.”

When Alecto Healthcare Services entered the West Virginia market, in Fairmont in 2014 and Wheeling three years later, the company hoped to find profit by stabilizing struggling hospitals. But when that didn’t work, Alecto did what businesses often do: cut its losses and shut down. Six months after it closed Ohio Valley, Alecto closed Fairmont Regional Medical Center, too.

“We were willing to take the risk,” said Michael Sarrao, the executive vice president and general counsel for Alecto Healthcare Services. “But you get to a point where there’s simply not enough revenue to support a hospital. It’s very hard to operate a hospital in today’s environment.”

Wheeling, W.Va. Photo by Gage Goulding.

When the two hospitals closed, more than 1,200 West Virginians lost their jobs. The closure of Ohio Valley was the third-largest layoff in West Virginia in the last decade, according to a review of more than 300 layoff notices submitted by companies to Workforce West Virginia. The closure of Fairmont Regional cost an additional 500 jobs. 

The combined closures of the hospitals culminated in the loss of 128 of the state’s inpatient psychiatric beds — nearly 10 percent.

For the last five years, West Virginia had the highest suicide rate east of the Mississippi River, according to data from the Center for Disease Control and Prevention. Yet, behavioral health resources are scarce. As suicide rates have risen annually in West Virginia over the last decade, behavioral health facilities have closed. It’s a loss the state’s residents can’t afford.

According to data from the U.S. Department of Health and Human Services, to meet the need for psychiatric care in West Virginia, the state would have to increase the number of practicing psychiatrists by 82%. It’s one of the highest deficits of care in the country.

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“The impact that I’ve seen [of hospital closures] has caused death,” Scott Pelley says.

What’s more, data from hospital financial reports show that while other departments struggled with low patient volumes, the inpatient psychiatric services at the hospitals were well-used, and the outpatient behavioral health offerings at Ohio Valley served approximately 1,600 patients.

Both Alecto and DHHR confirmed that meetings between the hospital owner and state officials took place regarding the future of the struggling facility prior to the closure of Ohio Valley, but no answers were found to prevent the mass layoff or save patient care.

Emails obtained through open record requests indicate that leaders of other West Virginia hospitals entered negotiations with Alecto that could have saved jobs and health care and prevented a complete closure, but Alecto did not engage.

“Somehow people need to know that Alecto and MPT have rejected legitimate offers,” wrote Douglass Harrison, CEO of Wheeling Hospital, in an email to other medical leaders in early September 2019. MPT is the property trust that owned the hospital buildings. 

The specifics of those offers are unclear. Sarrao, Alecto’s general counsel, did not comment, beyond to say that negotiations were unsuccessful.

A letter sent to Gov. Jim Justice by Alecto in the days following the closure cited a meeting with DHHR Secretary Bill Crouch on July 15, 2019. In the letter, Sarrao wrote the secretary “did not seem overly concerned” about the closure nor the loss of jobs. Sarrao also noted that previous requests to meet with the governor to discuss the closure of Ohio Valley were not returned, and thus no solution was found.

Suggestions listed in the letter from Alecto included urging the governor to provide a loan from the state to another local health system that could acquire the hospital, as had been done previously in Kentucky, and incentivizing the merger of the hospital with another larger provider in the area.

In a written response to questions posed by Mountain State Spotlight, DHHR said, “Maintaining behavioral health care has always been a priority … Secretary Bill Crouch worked with Gov. Justice and other concerned stakeholders in considering options and possible solutions to sustain and keep the financially challenged hospital operational.” 

Alecto closed the hospital with 28-days notice following its official announcement in August. That’s in compliance with West Virginia state requirements for the notification of patients upon closure, but is significantly less notice than is required in other states. Experts said it’s not enough time for patients to transition their care. 

The governor’s office and DHHR largely failed to find solutions that would preserve the jobs of hundreds of West Virginians and provide a continuation of care to the patients the hospital served. 

“You can sort of wrap your head around being discarded by some out-of-state company, but you don’t expect to be abandoned by your state,” said Connors, the former mental health technician in the Hillcrest behavioral health unit.

The former Hillcrest Behavioral Health Center. Photo by Lauren Peace.

In July 2020, about a year after Ohio Valley Medical Center in Wheeling closed, WVU Medicine opened a new behavioral health unit in the Northern Panhandle at Reynolds Memorial Hospital in Glen Dale. Connors is now working at that facility, about 10 miles south of Wheeling. She said the opening of the new behavioral health unit is a step in the right direction, but isn’t a complete replacement.

“I am so thankful that WVU stepped up and provided this region with a life-saving resource that was taken away,” said Connors. “But it’s only a small fix for mental health care in this state.”

According to Connors, the influx of new patients seeking psychiatric services at Reynolds has resulted in months of wait times for first-time patients. But Connors said in the interim, staff at the facility are working hard to get patients in with therapists.

“I don’t want people to be deterred,” said Connors. “There is help here.”

Still, she said one of the bigger challenges is connecting with previous patients, to make sure they’re able to find it. In the year since the hospital closed, she said she’s lost several of her former patients to overdoses or suicide.

“It seems like it’s one a week at this point,” Connors said.

 ‘He was good at asking for help’

When Colleen Smith moved to Wheeling in August 2018, she did so with few connections. She had come to the city to join a recovery program for people working through addiction. She felt vulnerable.

“I had a shell around me and wouldn’t let anyone in,” said Smith.

Colleen Smith. Photo by Lauren Peace.
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Colleen Smith remembers her friend, Joe Hubbard.

But on her first day in the program, a lanky man with a backward baseball cap made his way across the room to introduce himself. Joe Hubbard had been through the recovery program the year before, and knowing how hard the first day could be, he made a point to let Smith know that he was there to help.

“He was one of the first people in the room that made you feel welcome,” Smith said. “It allowed me to open up to other people so that I actually started healing. He just wouldn’t let me push him away.”

Hubbard struggled with substance abuse for years, using opioids to self-medicate for depression and to heal from childhood abuse. After an overdose nearly killed him, he landed in an addiction recovery program and got clean. 

Colleen Smith, Joe Hubbard, Stephen Powell and a fourth friend. Photo courtesy Colleen Smith.

He had been drug-free for a year at the time he met Smith, and soon a friendship formed. Scott Pelley, a senior member of Narcotics Anonymous with eight years in recovery, was a friend and father figure to them both.

The three offered each other a safety net, encouragement and support.

“We gave each other the time of day to air out anything without reprisal,” said Pelley. “Joe was phenomenal at that.”

Scott Pelley. Photo by Lauren Peace.

With Smith and Pelley, Hubbard began to open up about his struggles with his mental health. For the most part, he managed quietly, but when he fell into severe depression and feared he’d harm himself, he called on his friends. They helped him get to a safe place, typically Hillcrest at Ohio Valley Medical Center, and were there to support him as he got back on his feet.

“He struggled, but he was good at reaching out. He was good at asking for help,” Smith said. 

Pelley said it gave Hubbard peace of mind knowing that the hospital was there for him and, for the most part, he was doing really well.

“I watched Joe go from being homeless, to temporary housing, to getting his own place and reintegrating back in as a productive member of society,” said Pelley, recalling last spring when Hubbard used his money to buy a surprise Easter dinner for a local women’s shelter. “What a blessing that was.”

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Colleen Smith talks about Hubbard’s search for care.

But in 2019, Hubbard was hit with devastating news. His brother died. He lost his best friend a few months after. 

He began to feel “like death was all around him,” and was scared he would fall back into addiction without help. That’s why he was admitted as one of the final patients at Hillcrest as the hospital prepared to close in August 2019.

“Hillcrest was the place that he felt the most comfortable. That was his go-to,” Smith said.

When Hillcrest closed, the Northern Panhandle lost its largest inpatient psychiatric facility and a major provider of routine psychiatric care. It put strain on the community.

Then the pandemic hit, and community-based services became further limited. Recovery programs had to go virtual or shut down.

“We weren’t able to go to [NA] meetings,” said Smith. “[Joe] really lost his support system.”

Hubbard fell back into addiction. He no longer knew where he could go to get the help he needed; his safety net had been stripped away.

The week of his death, Smith said, Hubbard visited her at work. He told her he had tried to get help at Northwood Health Systems, another behavioral health center in downtown Wheeling. When Hillcrest closed, Northwood was able to fill some of the gaps in care. But the facility only had 16 available psychiatric beds compared to the 84 that were operated by the hospital, and it specialized in different services.

Hubbard told Smith the facility was full and couldn’t offer him overnight care.

“One of the last messages he sent me is asking if I knew of any other places he could go. Now that Hillcrest was gone I really didn’t know,” said Smith. “He didn’t deserve to be turned away like that and not get the help that he needed. He’d probably still be here if he did.”

Three days later, at 9:38 p.m., Pelley got a call that Hubbard had died.

“What does it look like when a hospital closes? The impact I see has caused death,” said Pelley. “Untreated mental illness kills. It’s just a matter of time.”

Eddie Hubbard, Joe’s older brother, said he hopes his brother is remembered for the way that he treated people — with kindness and respect.

Coming tomorrow: A hospital closed and state leaders didn’t act. Then, it happened again. Patients suffered the consequences. 

Ohio Valley Medical Center in Wheeling, W.Va. Photo by Lauren Peace.

Resources: Mental Health Clinics in West Virginia

Appalachian Community Health Center

Randolph County
Phone: (304)-636-3232 Or Toll-Free at 1-888-357-3232
Website: http://www.achcinc.org/
Hours of Operation: Monday through Friday, 8 a.m. to 5 p.m.

East Ridge Health Systems

Berkeley County
Phone: (304) 263-8954
24/7 Crisis Line: 1-855-807-1258
Website: https://www.eastridgehealthsystems.org/
Hours of Operation: Monday through Friday, 8 a.m. to 4 p.m.

Jefferson County
Phone: (304) 725-7565
24/7 Crisis Line: 1-855-807-1258
Website: https://www.eastridgehealthsystems.org/
Hours of Operation: Monday through Friday, 8 a.m. to 4 p.m.

Morgan County
Phone: (304) 258-2889
24/7 Crisis Line: 1-855-807-1258
Website: https://www.eastridgehealthsystems.org/
Hours of Operation: Monday through Friday, 9 a.m. to 4 p.m.

FMRS Health Systems, Inc.

Raleigh County
Phone: 304-256-7100
24/7 Crisis Line: 304-256-7100
Website: https://www.fmrs.org/

Fayette County
Phone: 304-574-2100
24/7 Crisis Line: 304-256-7100
Website: https://www.fmrs.org/

Monroe County
Phone: 304-772-5452
24/7 Crisis Line: 304-256-7100
Website: https://www.fmrs.org/

Summers County
Phone: 304-466-3899
24/7 Crisis Line: 304-256-7100
Website: https://www.fmrs.org/

HealthWays Inc.

Brooke County
Phone: 304-723-5440
24/7 Crisis Line: 304-723-6593
Website: https://www.healthwaysinc.com/
Hours of Operation: Monday through Friday, 8:30 a.m. to 5 p.m.

Logan Mingo Area Mental Health

Mingo County
Phone: (304) 235-2954
24/7 Crisis Line: (304)-235-2954
Website: http://www.lmamh.org/

Mingo County
Phone: (304) 475-3366
24/7 Crisis Line: (304)-235-2954
Website: http://www.lmamh.org/

Logan County
Phone: 304-792-7130
24/7 Crisis Line: (304) 792-7130
Website: http://www.lmamh.org/

Northwood Health Systems

Ohio County
Phone: 304.234.7777
Website: https://www.northwoodhealth.com/

Brooke County
Phone: 304.217.3050
Website: https://www.northwoodhealth.com/

Marshall County
Phone: 304.845.3000
Website: https://www.northwoodhealth.com/

Wetzel County
Phone: 304.455.3622
Website: https://www.northwoodhealth.com/

Potomac Highlands Mental Health Guild, Inc

Grant County
Phone: (304) 257-1155
24/7 Crisis Phone: 1-800-545-4357
Website: https://potomachighlandsguild.com/index.html

Pendleton County
Phone: (304) 358-2351
24/7 Crisis Phone: 1-800-545-4357
Website: https://potomachighlandsguild.com/index.html

Hampshire County
Phone: (304) 822-3897
24/7 Crisis Phone: 1-800-545-4357
Website: https://potomachighlandsguild.com/index.html

Hardy County
Phone: (304) 538-2302
24/7 Crisis Phone: 1-800-545-4357
Website: https://potomachighlandsguild.com/index.html

Mineral County
Phone: (304) 788-2241
24/7 Crisis Phone: 1-800-545-4357
Website: https://potomachighlandsguild.com/index.html

Prestera Centers for Mental Health Services

Boone County
Phone: (304) 369-1930
24/7 Crisis Phone: (877) 399-7776
Website: https://www.prestera.org/

Cabell County
Phone: (304) 525-7851
24/7 Crisis Phone: (877) 399-7776
Website: https://www.prestera.org/

Clay County
Phone: (304) 587-4205
24/7 Crisis Phone: (877) 399-7776
Website: https://www.prestera.org/

Kanawha County
Phone: (304) 341-0511
24/7 Crisis Phone: (877) 399-7776
Website: https://www.prestera.org/

Lincoln County
Phone: (304) 824-5790
24/7 Crisis Phone: (877) 399-7776
Website: https://www.prestera.org/

Mason County
Phone: (304) 675-2361
24/7 Crisis Phone: (877) 399-7776
Website: https://www.prestera.org/

Putnam County
Phone: (304) 414-3076
24/7 Crisis Phone: (877) 399-7776
Website: https://www.prestera.org/

Wayne County
Phone: (304) 272-3466
24/7 Crisis Phone: (877) 399-7776
Website: https://www.prestera.org/

Seneca Health Services Inc

Greenbrier County
Phone: (304) 497-0500
Website: https://shsinc.org/

Nicholas County
Phone: (304) 872-2659
Website: https://shsinc.org/

Pocahontas County
Phone: (304) 799-6865
Website: https://shsinc.org/

Webster County
Phone: (304) 847-5425
Website: https://shsinc.org/

Southern Highlands Community Mental Health Center

Mercer County
Phone: (304) 425-9541
24/7 Crisis Phone: (800)-615-0122
Website: https://shcmhc.com/
Hours of Operation: Monday through Friday, 9 a.m. to 5 p.m.

McDowell County
Phone: (304) 436-2106
24/7 Crisis Phone: (800)-615-0122
Website: https://shcmhc.com/
Hours of Operation: Monday through Friday, 9 a.m. to 5 p.m.

Wyoming County
Phone: (304) 294-5353
24/7 Crisis Phone: (800)-615-0122
Website: https://shcmhc.com/
Hours of Operation: Monday through Friday, 9 a.m. to 5 p.m.

Westbrook Health Services

Wood County
Phone: 304-485-1721
24/7 Crisis Phone: (304) 485-1725
Website: https://www.westbrookhealth.org/
Hours of Operation: Monday through Friday, 7:30 a.m. to 5 p.m.

Valley Healthcare System

Marion County
Phone: 304-366-7174
24/7 Crisis Phone: 1-800-232-0020
Website: http://www.valleyhealthcare.org/
Hours of Operation: Monday through Friday, 8 a.m. to 5 p.m.

Monongalia County
Phone: 304-296-1731
24/7 Crisis Phone: 1-800-232-0020
Website: http://www.valleyhealthcare.org/
Hours of Operation: Monday through Friday, 8 a.m. to 5 p.m.

Preston County
Phone: 304-329-1059
24/7 Crisis Phone: 1-800-232-0020
Website: http://www.valleyhealthcare.org/
Hours of Operation: Monday through Thursday, 9 a.m. to 5 p.m.

Taylor County
Phone: 304-265-3947
24/7 Crisis Phone: 1-800-232-0020
Website: http://www.valleyhealthcare.org/
Hours of Operation: Monday through Friday, 8 a.m. to 5 p.m.

United Summit Center

Crisis line: 1-800-786-6480

Serving the following counties:
Marion County
Barbour County
Braxton County
Gilmer County
Harrison County
Lewis County
Monongalia County
Preston County
Taylor County
Upshur County

Lauren Peace is a Report for America Corps Member who covers public health.