By On January 29th, 2014

Psych Beds Decline as Need Rises

PsychBedsA national news article was published by MedPage yesterday that described the severe lack of psychiatric beds (defined as a bed in a locked facility specializing in the treatment of psychiatric issues) in this country as it relates to public safety.  The facts are that violence committed by individuals in treatment for mental illness is rare.  Recent incidents covered in the news have involved people who have mental illness, and, for a myriad of reasons, have not received treatment.  The MedPage article opens by recalling such an incident that occurred last November when Virginia Senator, Creigh Deeds’ son stabbed his father and then took his own life.  This all occurred after Deeds’ son had been at the local emergency room.  Initial reports stated that he was only released from the medical hospital because there were no psychiatric beds available.  Later, this report was challenged when hospitals in the area stated they had available beds at the time, but were not contacted by the emergency room.

What happened in Virginia shines the light on many problems:  overloaded emergency rooms, issues with communication between medical and psychiatric facilities, lack of psych beds, difficulty in diagnosing mental illness and predicting violent behavior, and laws around holding someone against their will for treatment.  To focus in on the psych bed shortage, we need to look at the historical shifts regarding inpatient psychiatric treatment.  In 1955, we had 350 psych beds for every 100,000 people in the U.S.  By 2008, this had dropped to 17 beds per 100,000 people.  Most of the decline was due to a movement in the 1960s toward community mental health treatment in which people would be able to live at home and be treated on an outpatient basis.  There were positives about this sort of deinstitutionalization.  However, the need for stabilization and intensive treatment for those in crisis remained and options for this type of help declined.  The prison system has filled in the gaps since, and this is the new institution that houses many of our mentally ill community members.  Click here to learn more about the staggering statistics of people in our prisons and local jails with mental illness.

Oklahoma, already drastically short of psych beds, is set to be further impacted as the Oklahoma City hospital, Deaconess, prepares to close its 57 psych beds on February 10th.  Oklahoma is also one of the 45 states that has implemented Assisted Outpatient Treatment (AOT) programs to try to address the problem of people living in our community with severe mental illness.  An individual who receives court mandated treatment will be given a case manager to assist in making sure the individual is receiving treatment and medication.  This is good, but it is far from good enough.  We need both an increase in psych beds and more intensive follow up when individuals go home.  The bottom line is that we need to invest more money in treatment rather than waiting for the next tragedy to unfold after which blame and finger pointing will inevitably ensue.

Click here to read the MedPage article.

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