WEDNESDAY, MARCH 19, 2008
A 'Shortage' of Psychiatric Beds
A new comprehensive report [PDF] by the Treatment Advocacy Center says there is
a national shortage of nearly 100,000 in-patient beds for the mentally ill.
The center offers some fairly stunning background on the story:
Since the 1960s there has been a mass exodus of patients from public psychiatric hospitals. Data are available on the number of patients in such hospitals in 1955 and in 2004-2005. The data show that:
- In
2005 there were 17 public psychiatric beds available per 100,000
population compared to 340 per 100,000 in 1955. Thus, 95 percent of the
beds available in 1955 were no longer available in 2005.
- The
states with the fewest beds were Nevada (5.1 per 100,000), Arizona
(5.9), Arkansas (6.7), Iowa (8.1), Vermont (8.9), and Michigan (9.9).
The states with the most beds were South Dakota (40.3) and Mississippi
(49.7).
- A consensus of experts polled for this report
suggests that 50 public psychiatric beds per 100,000 population is a
minimum number. Thus, 42 of the 50 states had less than half the
minimum number needed, and Mississippi was the only state to achieve
this goal.
- The total estimated shortfall of public psychiatric beds needed to achieve a minimum level of psychiatric care is 95,820 beds.
- The
consequences of the severe shortage of public psychiatric beds include
increased homelessness; the incarceration of mentally ill individuals
in jails and prisons; emergency rooms being overrun with patients
waiting for a psychiatric bed; and an increase in violent behavior,
including homicides, in communities across the nation.
- The
consequences of the severe shortage in public psychiatric beds could be
improved with the widespread utilization of PACT (Program of Assertive
Community Treatment) programs and assisted outpatient treatment (AOT),
both of which have been proven to decrease hospitalization. It could
also be improved with greater flexibility in federal and state
regulations allowing for the development of alternatives to
hospitalization.
How to get local:
There are a few ways you can get to the core of the problem. Judges, public defenders and prosecutors often learn of shortages in psychiatric hospitals once the mentally ill hit the legal system. So, the mentally ill may wind up in jail, prison or on the street. A frustrated judge could be a great window to the situation.
The Treatment Advocacy Center says that "by using 50 public psychiatric beds per 100,000 population as a minimum, it is possible to compare the present bad capacity in each state with the minimum needed."
States with critical bed shortage (less than 12 beds per 100,000 population) include Nevada, Arizona, Arkansas, Iowa, Vermont, Michigan, Ohio, South Carolina, Oklahoma, Idaho and Alaska.
States with severe bed shortage (less than 12 to 19 beds per 100,000 population) include Florida, Texas, Rhode Island, Maine, Wisconsin, Hawaii, Colorado, North Carolina, New Hampshire, California, Tennessee and Georgia.
States with serious bed shortage (20 to 34 beds per 100,000 population) include Louisiana, Nebraska, Montana, Missouri, Maryland, Kansas, Alabama, Virginia, New Mexico, Wyoming, Connecticut, North Dakota, Minnesota, New York, New Jersey and Delaware. More specific figures are available in
the summary of the Treatment Advocacy Center's report.
Highlights from the report: Table 1 -- Degree of deinstitutionalization: Public pyschiatric beds per population, 1955 and 2004 to 2005 [PDF]
Table 2 -- Number of public psychiatric beds need to meet minimum standards of treatment [PDF]
U.S. Map -- Magnitude of shortage of shortage of public hospital beds for mentally ill persons [PDF]
Posted at 12:15:00 AM
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