State psychiatric beds are disappearing, and that could cost the United States billions of dollars

The number of state hospital beds dedicated to psychiatric care has dropped to record lows, even as the criminal justice system utilizes them more for inmate care.

The Treatment Advocacy Center, a national nonprofit focused on increasing the care of mental health patients, reported that almost half of the nation’s state hospital beds are in use by patients in the criminal justice system.

According to the report, the nation experienced a 17 percent reduction in the number of available psychiatric hospital beds since 2010. That’s a loss of more than 6,000 beds.

If you look at the past decade, the decline is even steeper. In 2005, there were just more than 50,000 state hospital beds available for psychiatric care. Today, it has shrunk to about 37,000 beds, or 11.7 beds available per 100,000 people, according to the report.

Pennsylvania ranks in the lower half of states in the nation for the availability of state hospital beds for psychiatric care.

The state has lost 500 beds since 2010, the fifth most of any state, and has only 10.4 beds available per 100,000 individuals, according to the report. Only 19 states have a lower number of available beds per capita than Pennsylvania.

Patients sometimes wait months for state psychiatric beds to open, and failure to receive treatment can lead to drug and alcohol abuse, emergency room visits, homelessness and increased incarceration rates.

The lack of adequate mental health care has cost the United States billions of dollars in lost income, according to leading mental health organizations.  

State psychiatric beds exist to primarily treat patients who cannot receive adequate and necessary treatment in a community setting, such as group homes. Common patients for these beds include uninsured individuals or patients who are deemed to be dangerous to themselves or others.

But state hospital psychiatric beds are also used by the criminal justice system for multiple purposes, and the center’s researchers found that nearly half of the beds in the country are filled by patients who are awaiting trial or have already been convicted of a crime.

State psychiatric beds can be filled by criminal defendants being “restored” to competency to stand trial, defendants deemed to be “unrestorable” or convicted prisoners in need of intensive psychiatric care, among others.

Almost 47 percent of state hospital beds across the nation are dedicated solely to patients within the criminal justice system.

Part of the problem, according to the report’s researchers, is that community and outpatient facilities designed to replace state psychiatric systems were simply never built. As the nation moved away from large, state-run psychiatric facilities, hundreds of thousands of beds were lost in the process.

The study’s recommendations include increasing the number of beds per 100,000 people to the range of 40 to 60, especially in targeted areas. As well, the researchers recommend Congress to fund a “comprehensive review” of Medicare and Medicaid regulations that they believe to be harmful to psychiatric treatment.

In June, U.S. Rep. Tim Murphy, R-Pa., introduced a bill to the House of Representatives that would increase the number of state psychiatric hospital beds. One aspect of HR 2646 would be to provide “additional psychiatric hospital beds for those experiencing an acute mental health crisis and in need of short term immediate inpatient care for patient stabilization.”

Other provisions in the bill include creations of a new position and committee to focus on mental health issues at the federal level. The bill was unanimously voted out of the House Energy and Commerce Committee last month. The Pittsburgh Post-Gazette reported Murphy is confident the bill will pass the House.

“The key is compassion in dictating what we can do for people,” Murphy recently told the Washington Post.

Reach Iain Oldman at ioldman@publicsource.org. Follow him on Twitter @iainoldman.