# Should Psych Wards Be Mandatory? **URL:** \ **Category:** Great Debates\ **Created:** [May 21, 2019, 8:02pm UTC](https://boards.straightdope.com/t/should-psych-wards-be-mandatory/834313 "2019-05-21T20:02:48Z")\ **Posts on this page:** 16\ **Page:** 1
**Author:** ![Jim\_B](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jim_b/32/4338_2.png) [@Jim\_B](https://boards.straightdope.com/u/Jim_B)\ **Post date:** [May 21, 2019, 8:02pm UTC](https://boards.straightdope.com/t/should-psych-wards-be-mandatory/834313/1 "2019-05-21T20:02:48Z")
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? :):)🙂 ---
**Author:** ![Max\_S](https://avatars.discourse-cdn.com/v4/letter/m/46a35a/32.png) [@Max\_S](https://boards.straightdope.com/u/Max_S)\ **Post date:** [May 21, 2019, 8:24pm UTC](https://boards.straightdope.com/t/should-psych-wards-be-mandatory/834313/2 "2019-05-21T20:24:54Z")
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. [1]Japsen, B. (February 25, 2018). _Psychiatrist Shortage Escalates As U.S. Mental Health Needs Grow_. Forbes. Retrieved from [Psychiatrist Shortage Escalates As U.S. Mental Health Needs Grow](https://www.forbes.com/sites/brucejapsen/2018/02/25/psychiatrist-shortage-escalates-as-u-s-mental-health-needs-grow/) [2] Raphelson, S. (March 9, 2018). _Severe Shortage of Psychiatrists Exacerbated By Lack Of Federal Funding_. NPR. Retrieved from [Severe Shortage Of Psychiatrists Exacerbated By Lack Of Federal Funding : NPR](https://www.npr.org/2018/03/09/592333771/severe-shortage-of-psychiatrists-exacerbated-by-lack-of-federal-funding) [3]Kyanko, K. A. & Busch, S. H. (December 3, 2018). _There’s a shortage of psychiatrists for those most in need_. The Hill. [Editorial]. Retrieved from [https://thehill.com/opinion/healthcare/419309-theres-a-shortage-of-psychiatrists-for-those-most-in-need](https://thehill.com/opinion/healthcare/419309-theres-a-shortage-of-psychiatrists-for-those-most-in-need) ~Max ---
**Author:** ![Kent\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kent_clark/32/105_2.png) [@Kent\_Clark](https://boards.straightdope.com/u/Kent_Clark)\ **Post date:** [May 21, 2019, 8:32pm UTC](https://boards.straightdope.com/t/should-psych-wards-be-mandatory/834313/3 "2019-05-21T20:32:33Z")
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.](https://en.m.wikipedia.org/wiki/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. ---
**Author:** ![Max\_S](https://avatars.discourse-cdn.com/v4/letter/m/46a35a/32.png) [@Max\_S](https://boards.straightdope.com/u/Max_S)\ **Post date:** [May 21, 2019, 8:42pm UTC](https://boards.straightdope.com/t/should-psych-wards-be-mandatory/834313/4 "2019-05-21T20:42:02Z")
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): _Beyond Beds_. (2017). Treatment Advocacy Center. Retrieved from [Beyond Beds - Treatment Advocacy Center](https://www.treatmentadvocacycenter.org/beyond-beds) ~Max ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [May 21, 2019, 11:35pm UTC](https://boards.straightdope.com/t/should-psych-wards-be-mandatory/834313/5 "2019-05-21T23:35:00Z")
Not enough psychiatric practitioners to staff them, and most folks don’t have insurance to cover inpatient psychiatric care, which is NOT cheap. ---
**Author:** ![septimus](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/septimus/32/410_2.png) [@septimus](https://boards.straightdope.com/u/septimus)\ **Post date:** [May 24, 2019, 5:33am UTC](https://boards.straightdope.com/t/should-psych-wards-be-mandatory/834313/6 "2019-05-24T05:33:51Z")
> [@Kent\_Clark](#): > > The problems with public hospitals came from the mntal health reforms of the 70s, culminating in the [Mental Health Systems Act of 1980.](https://en.m.wikipedia.org/wiki/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. 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). > [@](#): > > 1967 Ronald Reagan is elected governor of California. At this point, the number of patients in state hospitals had fallen to 22,000 [from 37,000 in 1959], and the Reagan administration uses the decline as a reason to make cuts to the Department of Mental Hygiene. They cut 2,600 jobs and 10 percent of the budget despite reports showing that hospitals were already below recommended staffing levels. > > 1967 Reagan signs the Lanterman-Petris-Short Act and ends the practice of institutionalizing patients against their will, or for indefinite amounts of time. This law is regarded by some as a “patient’s bill of rights”. Sadly, the care outside state hospitals was inadequate. **The year after the law goes into effect, a study shows the number of mentally ill people entering San Mateo’s criminal justice system doubles.** ---
**Author:** ![l0k1](https://avatars.discourse-cdn.com/v4/letter/l/bb73d2/32.png) [@l0k1](https://boards.straightdope.com/u/l0k1)\ **Post date:** [May 24, 2019, 11:16am UTC](https://boards.straightdope.com/t/should-psych-wards-be-mandatory/834313/7 "2019-05-24T11:16:19Z")
How about we just make mental healthcare a public service? The government will pay for treatment, including in patient care if necessary. ---
**Author:** ![USCDiver](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/uscdiver/32/354_2.png) [@USCDiver](https://boards.straightdope.com/u/USCDiver)\ **Post date:** [May 24, 2019, 11:36am UTC](https://boards.straightdope.com/t/should-psych-wards-be-mandatory/834313/8 "2019-05-24T11:36:24Z")
> [@l0k1](#): > > How about we just make mental healthcare a public service? The government will pay for treatment, including in patient care if necessary. 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. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [May 24, 2019, 12:34pm UTC](https://boards.straightdope.com/t/should-psych-wards-be-mandatory/834313/9 "2019-05-24T12:34:58Z")
> [@USCDiver](#): > > 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. ---
**Author:** ![l0k1](https://avatars.discourse-cdn.com/v4/letter/l/bb73d2/32.png) [@l0k1](https://boards.straightdope.com/u/l0k1)\ **Post date:** [May 24, 2019, 1:16pm UTC](https://boards.straightdope.com/t/should-psych-wards-be-mandatory/834313/10 "2019-05-24T13:16:02Z")
OK, let’s not make public healthcare shitty then. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [May 24, 2019, 1:51pm UTC](https://boards.straightdope.com/t/should-psych-wards-be-mandatory/834313/11 "2019-05-24T13:51:35Z")
> [@l0k1](#): > > OK, let’s not make public healthcare shitty then. 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. OK, I’ll get off my soap box now . . . ---
**Author:** ![SuperAbe](https://avatars.discourse-cdn.com/v4/letter/s/f17d59/32.png) [@SuperAbe](https://boards.straightdope.com/u/SuperAbe)\ **Post date:** [May 24, 2019, 1:59pm UTC](https://boards.straightdope.com/t/should-psych-wards-be-mandatory/834313/12 "2019-05-24T13:59:16Z")
> [@Qadgop\_the\_Mercotan](#): > > OK, I’ll get off my soap box now . . . 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.) ---
**Author:** ![susan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/susan/32/17537_2.png) [@susan](https://boards.straightdope.com/u/susan)\ **Post date:** [May 24, 2019, 8:02pm UTC](https://boards.straightdope.com/t/should-psych-wards-be-mandatory/834313/13 "2019-05-24T20:02:24Z")
I consider it important to take Medicare and Medicaid as a mental health practitioner. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [May 24, 2019, 8:50pm UTC](https://boards.straightdope.com/t/should-psych-wards-be-mandatory/834313/14 "2019-05-24T20:50:03Z")
> [@susan](#): > > I consider it important to take Medicare and Medicaid as a mental health practitioner. Thanks for doing that. But we still need a better system. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [May 24, 2019, 11:14pm UTC](https://boards.straightdope.com/t/should-psych-wards-be-mandatory/834313/15 "2019-05-24T23:14:10Z")
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. ---
**Author:** ![nelliebly](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/nelliebly/32/5422_2.png) [@nelliebly](https://boards.straightdope.com/u/nelliebly)\ **Post date:** [May 25, 2019, 3:49am UTC](https://boards.straightdope.com/t/should-psych-wards-be-mandatory/834313/16 "2019-05-25T03:49:30Z")
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. Anyway, how DO we get more shrinks?