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Newly updated to include breast cancer, prostate cancer, and spine procedures, this CHCF-sponsored research shows that practice patterns vary dramatically from place to place.

Medi-Cal Transforms

Medi-Cal is the main source of health insurance for one in five Californians. An updated report gives an overview of the program's key features, describes how the program is evolving, and examines the challenges ahead.

Obama Care in the Second Term

CHCF is a long-time sponsor of the UC Irvine Forecast Conference. A webcast of this year's conference on health policy in President Obama's second term is now available.

Mental Health

Friday, July 20, 2012

Treatment of Patients in Psychiatric Hospitals Down, Report Finds

In 2010, California hospitals served 16% fewer patients with mental illnesses than state hospitals did in 2005, according to a report released Thursday by the Treatment Advocacy Center, the Los Angeles Times reports.

Background

In 1999, the U.S. Supreme Court ruled that public entities must administer psychiatric services and programs in the "most integrated setting appropriate." The ruling also applied to people with developmental disabilities.

According to the Times, the ruling encouraged a trend of deinstitutionalizing patients who were not under the jurisdiction of criminal courts.

Doris Fuller -- executive director of the Treatment Advocacy Center -- said that although the ruling clearly stated that hospitals should not be forced to release patients too ill to care for themselves, it "has widely been used mistakenly as a justification to do just that."

U.S. Findings

According to the report, the number of state hospital psychiatric beds nationwide decreased by 14% from 2005 to 2010, forcing individuals with mental illnesses into emergency departments, jails and prisons.

The report states that "95% of the nation's public psychiatric hospital beds (have) disappeared," while "community psychiatric care exists for fewer than half the patients who do need it."

California Findings

The report found that California hospitals served 5,283 patients in 2010.

According to the report, about 92% of psychiatric beds in the state now are occupied by patients from the criminal justice system.

Researchers did not study the availability of psychiatric beds for acutely ill patients in county or privately run facilities. The California Hospital Association said that the number of psychiatric beds decreased by 30% between 1995 and 2010.

Report Recommendations

The report encouraged states to treat patients with mental illnesses in community facilities whenever possible, rather than institutionalizing them. It called on states to stop reducing the number of psychiatric hospital beds until there are enough alternatives available at community facilities.

It also recommended that states:

  • Increase the use of court-ordered outpatient treatment for patients who are too sick to seek help; and
  • Boost Medicaid coverage for psychiatric patients in state hospitals (Romney, Los Angeles Times, 7/20).

Reader Comments:
  • 1
  • 07/23/2012
  • Michael McLeran

Community MH system is broke. Crisis workers are told to avoid acute care admissions (5150) and initiate involuntary admits only as a last resort. Crisis staff spend hours upon hours in the ER trying to find less costly alternatives, it's a drama played out nightly and it's a pressure cooker for the crisis worker and a raw deal for the client. What to do? Bus ticket, motel voucher, AA, shot of Haldol, Demerol maybe? Acute care and SNF bed days are down due to a broken down financially devastated MH system. The state washed it's hands clean and handed the problem to the communities. "Here's your money, spend it wisely and don't come back asking for more, oh, and by the way, we are turning NSH into a penal colony so take that." The goal of Community Mental Health is to treat mental illness however acute and persistent it may be. Give your local crisis worker a hug, the burden often falls on their shoulders in the middle of the night. They have very few treatment options.



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