I actually just came up with this idea, possibly last night as I slept. Should large hospitals be required to have psychiatric wards in them?
True story. In 1997 my father had a nervous breakdown. He wasn’t violent. But he was a little combative. So we had to have him involuntarily committed. So we put him in a private hospital.
And I have to tell you, it really was a wonderful place. The staff was so committed and compassionate. And when he was done in the inpatient, he went into partial hospitalization, which was common at the time.
Michigan governor Engler closed down all the public hospitals in the 90’s. Now there aren’t even any private hospitals for these poor people to get treatment. Where can they go?
When my father was hospitalized, they told us mental illness is a biological-based brain disease. So I know that there aren’t any less sick people out there.
And most of them aren’t violent (media reports to the contrary notwithstanding). It’s just when they dump them on the street, they dump EVERYONE.
I am going to try to share this idea with everyone the next time I go on my PC. But what do the rest of you think of it for now?
I’m not sure if there are enough professionals to add on a mandatory psych ward[1][2][3]. These psychiatric institutions came under quite a bit of criticism from the 1960s on, particularly the anti-psychiatry movement, and I suspect that was a factor in their decline.
Required? No, that would mean at least some of these facilities would have a poor staff. There are still plenty of private hospitals with psychiatric sections.
The problems with public hospitals came from the mntal health reforms of the 70s, culminating in the Mental Health Systems Act of 1980.. Unfortunately, the follow-up - outpatient therapy with continuing follow-up, didn’t happen.
Just like with every other type of illness in the United States, it sucks to be poor.
For when you do make the full argument, here’s a treatment advocacy center report on the shortage of psychiatric beds (Treatment Advocacy Center is all about psychiatric treatment):
Decline in psych wards began before the 1970’s. In fact, the number of patients inside public mental hospitals nationwide apparently peaked in 1955 at 560,000. Thorazine appeared on the market about then and was thought to be a panacaea.
Ronald Reagan was widely despised for sending the mentally ill onto the streets as Governor of California (though his personal blame may be exaggerated).
Depending on the pay rates, it may make things worse. If private insurance no longer covers the service and reimbursement goes down then there will be even fewer Psychiatrists.
Yeah, at Medicare/Medicaid reimbursement rates, we’ll lose more psychiatric practitioners. They’re so few as is that they can currently get well over $200/hour in my area of the country. And we still can’t find enough to serve our population at that price.
Maybe we need to decide to have general public healthcare. AND do a good job at it.
I’ve been in the public sector, serving the health care needs of incarcerated felons for over 17 years now. My outfit doesn’t do too badly with the resources we’re given but we certainly need more if we’re going to do anything about the current hepatitis C epidemic in the US, much less make sure our folks leaving prison have access to continued psychiatric care. Lack of said access leads many of them to stop their meds when they run out, miss out on counselling and end up back in prison all too quick.
Please don’t: we need more docs on this particular soap box, not fewer.
(In all seriousness, please, keep speaking up about this: it’s the only way we might see meaningful improvements in the public health care system. And I know you know that.)
In patient psychiatric care is very expensive, around $1000 a day.
By comparison jail is closer to $100 a day.
With the advent of a wide variety of antipsychotic and other medications for severe mental illness, a lot of hospitals were closed down in the 60s and 70s because it was felt that people could function in the community on medication. The hospitals were ‘supposed’ to be replaced with community centers, but they never were.
So now the seriously mentally ill wander the streets until they end up in prison.
So how do we get more mental health professionals into the field? There’s such a severe shortage that in rural areas, people who badly need treatment go without. There are also so few in-patient facilities. In all of Wyoming, there’s one in-patient psychiatric facility.
I wish we could get more and better coverage for mental illness. As soon as I raise this, conservative friends start in with how all these bored people with no real problems would lounge on psychotherapy couches (Their knowledge of therapy comes from old cartoons.) all day on the taxpayers’ dime. The only time they seem to veer from that is when there’s been a mass shooting, and then they clam right up when I ask if they’d be willing to pay a bit more in taxes.
