Of the remaining beds, approximately half were occupied by patients charged or convicted of crimes, leaving about 6 state hospital beds per 100,000 people for civil patients, the study reported. By comparison, the average number of psychiatric beds in the 34-member Organization for Economic Cooperation and Development is 68 beds per 100,000 people, virtually all of them public.
"These beds represent the psychiatric equivalent of ICU patient beds. We are forcing acutely ill people to suffer terribly instead of making treatment available the way we would for any other medical condition," said John Snook, executive director of the Treatment Advocacy Center. "The loss of beds loss has been disastrous for our nation and those most in need."
The study found a host of consequences from the bed shortage, including near-universal "boarding" of psychiatric patients in hospital emergency rooms, widespread waiting lists for hospital admission from jails and prisons, and pending or threatened civil rights lawsuits against states from coast to coast. States struggling to cope with surging demand for inpatient services to mentally ill criminal offenders increasingly are reducing access to last-resort hospital beds to non-offenders.
"A bed shell game with life-and-death implications has ensued" in which "one population benefits somewhat, at the expense of the other," the study said.
To reduce shortages and their impacts, the Treatment Advocacy Center recommends:
- A moratorium on closing any of the remaining last-resort beds in state psychiatric hospitals
- A federal initiative to determine a safe minimum number of psychiatric beds to meet inpatient need and demand
- A congressional effort to identify and reform federal policies that create financial incentives for closing both public and private beds
- Improved data collection to support evidence-based public policies that will either reduce bed demand, increase bed supply or both
- Increased use of diversion strategies that reduce hospitalization rates, including assisted outpatient treatment, assertive community treatment and the Sequential Intercept Model
Going, Going, Gone is the Treatment Advocacy Center's fourth survey of psychiatric bed populations since 2008. Combining data collection in every state and the District of Columbia with statistics developed for the federal government, it represents the most complete and up-to-date source of state hospital bed data available, including the number of civil and forensic beds remaining in every state.
"This report should serve as a wake-up call to decision makers that our failed mental health policies must be reformed," Snook said. "There is blood on the hands of every legislator who chooses to continue ignoring this emergency."