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Shortage of Psychiatric Beds in the USA

Puppycow

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Puppycow
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This happened recently:

Police: Son likely stabbed Va. state Sen. Creigh Deeds, shot himself

The day before he stabbed his father at the family’s home, the son of Virginia state Sen. R. Creigh Deeds (D) underwent a psychiatric evaluation but was not admitted to a hospital because no bed was available.

Deeds was listed in fair condition late Tuesday after his son, Austin, stabbed him in the face and chest, then shot himself in what investigators described as an apparent attempted murder and suicide.
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Which reminded me of something I heard not too long ago, which is that there are not enough beds at psychiatric hospitals in the USA to meet the demand:
Severe Shortage of Psychiatric Beds Sounds National Alarm Bell

Report finds US deficit of nearly 100,000 inpatient beds; result is increased homelessness, emergency room overcrowding, and use of jails and prisons as de-facto psychiatric hospitals

A March 2008 report by the Treatment Advocacy Center reveals that for every 20 public psychiatric beds that existed in the US in 1955, only one such bed existed in 2005.

According to data cited in The Shortage of Hospital Beds for Mentally Ill Persons, in 1955 there were 340 public psychiatric beds available per 100,000 U.S. citizens. By 2005, the number plummeted to a staggering 17 beds per 100,000 persons. Mississippi was found to have the most beds available in 2005 (49.7 per 100,000 people), while Nevada (5.1) and Arizona (5.9) had the least. For the complete report, state-by-state ranking of beds lost, and list of recommendations click here.

“The results of this report are dire and the failure to provide care for the most seriously mentally ill individuals is disgraceful,” said lead author, Dr. E. Fuller Torrey, president of the Treatment Advocacy Center. “Our communities are paying a high price for our failure to treat those with severe and persistent mental illness, and those not receiving treatment are suffering severely. In addition, untreated persons with severe mental illnesses have become major problems in our homeless shelters, jails, public parks, public libraries, and emergency rooms and are responsible for at least 5 percent of all homicides.”
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This tragic result seems to a stark reminder of the problem and its real-life consequences. If only a bed had been available, this wouldn't have happened.
 
Puppycow said:
This happened recently:
Which reminded me of something I heard not too long ago, which is that there are not enough beds at psychiatric hospitals in the USA to meet the demand:
Severe Shortage of Psychiatric Beds Sounds National Alarm Bell


This tragic result seems to a stark reminder of the problem and its real-life consequences. If only a bed had been available, this wouldn't have happened.
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Take one guess why this is!? 99% of all free market majik solution (according to anti aca right wingers anyway) health insurance policies simply don't cover mental illness!

Why - it's not profitable, so like in many cases, the fall back republican plan applies.
Pay for it your self, cant pay for it or mony doesn't help - let them die.


The left should be using this as a stark vivid examply on why we need UHC/healthcare reform, because mental illness or cancer, in this extreme form of violance or in the slow weardown of years of suffering, a lot of preventable/manageable disease has this needless
tragic result.
 
Magyar said:
Take one guess why this is!? 99% of all free market majik solution (according to anti aca right wingers anyway) health insurance policies simply don't cover mental illness!
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The free market balances the supply of goods with the demand for goods through prices. It is not a cure for social ills and anyone who claims such is either a liar or a fool.

Magyar said:
Why - it's not profitable, so like in many cases, the fall back republican plan applies.
Pay for it your self, cant pay for it or mony doesn't help - let them die.
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It wasn't a conservative idea that closed the doors to mental institutions years ago, it was the belief that it was cruel to keep people confined to mental hospitals their entire lives. And courts have put severe limits on confining people to mental hospitals against their will.

Magyar said:
The left should be using this as a stark vivid examply on why we need UHC/healthcare reform, because mental illness or cancer, in this extreme form of violance or in the slow weardown of years of suffering, a lot of preventable/manageable disease has this needless
tragic result.
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Bad comparison. The problem with mental illness is there is no cure, only a lifetime of expensive treatment which relies in large part on the willingness of the patient, who often doesn't think they're ill, to get treatment.

It'd be nice if we could have a discussion of this issue without knee-jerk political partisanship poisoning the discussion.
 
Magyar said:
Take one guess why this is!? 99% of all free market majik solution (according to anti aca right wingers anyway) health insurance policies simply don't cover mental illness!

Why - it's not profitable, so like in many cases, the fall back republican plan applies.
Pay for it your self, cant pay for it or mony doesn't help - let them die.


The left should be using this as a stark vivid examply on why we need UHC/healthcare reform, because mental illness or cancer, in this extreme form of violance or in the slow weardown of years of suffering, a lot of preventable/manageable disease has this needless
tragic result.
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I think that mental illness is the one kind of disease that nobody thinks they could get (or most people anyway). People worry that they might get cancer, but nobody thinks that they or a loved one might become mentally ill until it actually happens. So they think of it as someone else's problem. That's why they think they don't need coverage for it, but they do want coverage for cancer.
 
WildCat said:
It wasn't a conservative idea that closed the doors to mental institutions years ago, it was the belief that it was cruel to keep people confined to mental hospitals their entire lives. And courts have put severe limits on confining people to mental hospitals against their will.
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I remember reading One Flew Over the Cuckoo's Nest in high school. Maybe that had something to do with it. Of course, there's issues with the way they used to do things too, as described in the book, although admittedly fiction with an agenda. Mental hospitals were somewhat like warehouses for the mentally ill, little better than prisons in some cases.

So there's probably no perfect solution.
 
The ACA is supposed to fix this, thereby lower the mass murder rate too.

THAT's why its in Politics.
 
I think this topic is more complicated than it might first appear, and will look different from various perspectives. As part of the ongoing health care debate, "right wingers" may be expected to be generally more averse to solutions that increase the cost burden on taxpayers, and Ronald Reagan has long been implicated as having a key role in the deinstitutionalization of mental health care, and while I enjoy a good Reagan-bashing as much as the next guy, I feel duty bound to point out that advocates for the rights of the mentally ill played a part as well, with the ACLU fighting against involuntary institutionalization -- and those considerations cannot easily be cast aside. My guess is that mental illness would continue to be a difficult thing to deal with even in a perfect world in which each individual were in the setting most ideal for them.

One quote from the second link in the OP stands out for me:
"Studies have shown that between 5 to 10 percent of seriously mentally ill persons who are not receiving treatment will commit a violent act each year. Such individual are responsible for at least 5 percent of all homicides."

The implication is that 95% of homicides are committed by individuals who are either sane or mentally ill but receiving treatment. Clearly, not everyone will define "mentally ill" in exactly the same way. Not all societies will define it in exactly the same way. It might even go state-by-state. I don't know about Nevada, but there might be some places where a person would meet the criteria for "mentally ill", but if you shipped them off to California, they wouldn't be any crazier than anyone else. Poof! Cured!

I have a sister who has suffered from untreated bipolar disorder for many years. About as bad as it gets, I'd say. Despite having been briefly institutionalized following quasi-suicide attempts (lying down in the middle of a busy street, that sort of thing), she continues to reject the diagnosis (as so many of them do), and therefore has never been compliant for long with any form of treatment. The closest thing she has to a med regimen usually consists of crack, crank, booze, and I don't know what all. Her lifestyle has not permitted us to stay in close contact. I'm okay with that, as her behavior tends to wreak havoc on the lives of those around her as well as her own, and I don't see myself being able to do much for her anyway. As long as she denies having a problem, it's going to be her against "them", and any suggestion that she needs help gets you placed automatically in the "them" category. We have had a few phone conversations during which she was lucid, but she tends not to call me during those phases. It's more often when she is in "forced speech" mode, where there doesn't seem to be much point -- I told her once that I didn't see why there even needed to be anyone on the other end of the line if that person never gets a word in edgewise, but I'm pretty sure she didn't hear me, what with her talking so fast, loud, and non-stop. I've had to block her number with my caller ID a few times. Sometimes actions speak louder than words. If all you want to do is spew poison, call 900 SPEW POISON or whatever, but homie don't play that game. Got my own life.

I have long been of the opinion that "sanity" is a rather slippery concept in general. One of the things I've told my sister is that "crazy is as crazy does"; that, for instance, no one gets 86'ed from a homeless shelter for being crazy; it's acting crazy that does it -- specifically, acting in a way that gets you profiled as a threat to others. I think that may actually have stuck, but who knows?

I agree with Puppycow -- there probably are no perfect solutions. The trick would seem to be not to allow the perfect to be the enemy of the good. (Maybe we're not even at that stage; right now, not allowing the good to be the enemy of the barely adequate might be a big enough step up).

I also agree with Wildcat -- it would be nice if we could have a discussion of this issue without knee-jerk political partisanship poisoning the discussion. Unfortunately, I don't see that as possible given the current political environment. (Not about this issue, or just about any other issue).
 
Here in Capitol City, there's definitely a shortage. Patients are often warehoused in the hospital due to the lack of beds at mid-Michigan facilities.
 
WildCat said:
The free market balances the supply of goods with the demand for goods through prices. It is not a cure for social ills and anyone who claims such is either a liar or a fool.
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Correct me why im wrong, but isnt that, Exactly, what the teaparty, the gop is claiming now and when they invented the aca as an alternative to uhc!? And isnt this reason exactly why every other civilized nation has gone to uhc, of one kind or another. Because they recognize wt providing healthcare to everyone regardless of ability to pay does a far better job at addressing those social ills and is a higher priority to society then profit margin.

So NO, its not a knee jerk reaction!

It wasn't a conservative idea that closed the doors to mental institutions years ago, it was the belief that it was cruel to keep people confined to mental hospitals their entire lives. And courts have put severe limits on confining people to mental hospitals against their will.
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Maybe, But it is the insurance companies and their political surragates on the right who are preventing coming up with a modern more humane and affordable solution by fighting tooth and nail to preserve the status quo.

Bad comparison. The problem with mental illness is there is no cure, only a lifetime of expensive treatment which relies in large part on the willingness of the patient, who often doesn't think they're ill, to get treatment.

It'd be nice if we could have a discussion of this issue without knee-jerk political partisanship poisoning the discussion.
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Yes but treatment is expensive and the social programs that would allow these patients support to stay with their programs are precisely the ones targeted for extreme cuts by right wingers in favor of more wealth transfer to the 1%. So sorry it is very political, however there is nothing knee jerk about my coments.
 
It looks as though the costs to society are far greater than the treatment costs (at least for schizophrenia).

Page 30 of the NICE guidelines lists economic costs for various Western countries.


http://www.nice.org.uk/nicemedia/live/11786/43607/43607.pdf

It is mostly the loss of productivity of the individual as well as the loss of productivity for the carers.

The stigma associated with having schizophrenia appears to be the greatest barrier to employment.
 
Tatyana said:
It looks as though the costs to society are far greater than the treatment costs (at least for schizophrenia).

Page 30 of the NICE guidelines lists economic costs for various Western countries.


http://www.nice.org.uk/nicemedia/live/11786/43607/43607.pdf
It
It is mostly the loss of productivity of the individual as well as the loss of productivity for the carers.

The stigma associated with having schizophrenia appears to be the greatest barrier to employment.
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right and your point!? Unless I miss understood, your claim is that profit margin is the only thing that matters? Didnt a few places through history try that solution already and was totally regected by the st of the civilized world.
 
Magyar said:
right and your point!? Unless I miss understood, your claim is that profit margin is the only thing that matters? Didnt a few places through history try that solution already and was totally regected by the st of the civilized world.
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My point is that even if you only consider economics, it makes sense to take care of people with mental health issues.
 
A part of the problem seems to me, as has been mentioned, that nobody thinks they could ever fall mentally ill. I've seen quite a few people, even on this forum, bash the ACA requirements because "they don't need mental illness coverage". And well, they don't. Until they do. And before they realize they do, they might be dead.
 
Tatyana said:
My point is that even if you only consider economics, it makes sense to take care of people with mental health issues.
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This is where the entire right fails to understand the actual economics of healthcare in general.
 
Maybe someone wasn't trying hard enough?
http://www.cnn.com/2013/11/20/politics/virginia-politician-attack/index.html?hpt=hp_t2
But Dennis Cropper, executive director of the Rockbridge Area Community Services Board, said that Austin Deeds had been released because no psychiatric bed could be found for him across a wide area of western Virginia, the newspaper reported. But three hospitals in the area told CNN Wednesday that they had beds available, and no one called them. All three are within an hour or two of the Deeds family home in Millboro, about 150 miles west of Richmond.
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Ranb
 
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