Stuck In Line: The Psychiatric Bed Crisis

Bridget Seelinger, DUSNA Publicity Chair

The Pennsylvania Medical Society is calling for legislation regarding the ability to find inpatient beds for psychiatric patients. During the society’s annual House of Delegates, 200 physicians endorsed the idea of creating a voluntary bed-tracking system for the entire state, so that patients can be placed in a psychiatric facility faster and more efficiently. State Representative Dan Miller- D. Mt. Lebanon has introduced a bill to address this concern, but the legislation hasn’t gotten anywhere, to the frustrawestern psychtion of supporters.

When a psychiatric
patient presents to an emergency department that patient can remain waiting for placement in a facility for hours, sometimes even days.  According to Bruce McLeod, President of the PA Medical Society, there is a dire need for reform.

“Quite often, psychiatric patients experiencing a health problem will end up in the emergency department. When that happens, it is important to find them appropriate care quickly,” he says, “It’s not unusual for a psychiatric patient to spend hours in the emergency department while staff members try to track down an available bed.”

MSNBC reported back in 2013 about the bed crisis that has been affecting all of America, not just Pennsylvania. According to the story, state budget cuts and the movement of care into the community have left questions as to what patients are supposed to do while in between the inpatient and outpatient settings. The answer? Languishing in the ER until a bed opens up.

Many states have chosen to downsize the amount of beds open in an effort to place more emphasis on community resources by the closing of state hospitals. In states like Minnesota, this has resulted in the “warehousing” of committed psychiatric patients into catch-all psychiatric units in hospitals unequipped to deal with this patient population and unable to properly treat these patients. Patients end up waiting in these units for months instead of getting the treatment that they need. County jails have also been filling up with patients in Minnesota, sometimes taking higher spots on waiting lists and further clogging up the system.

“This is about as bad as I’ve ever seen it,” said Roberta Opheim, Minnesota’s state mental health ombudsman. “People [hospitalized with severe mental illnesses] have no place to go, but they can’t just be put on the street.”

According to the Pittsburghmental health Post-Gazette, though, the problem isn’t that there aren’t enough beds available. The problem is that no one knows where these open beds are.

The Allegheny Health Department reports in most recent figures that psychiatric hospitals within Allegheny County have occupancy rates of 59.5-94.3%. The hospitals are not completely full, yet patients are still left waiting.

Camellia Herisko, Chief Nursing Officer and Vice President of Patient Care services at Western Psychiatric Institute and Clinic says that UPMC is working on a system for UPMC and non-UPMC emergency departments.

“Bed availability can be challenging. So to ensure we are providing the most effective care to our patients, we are developing new and creative strategies to address this,” she says.

These sorts of systems are not a miracle fix for the problem, though. Iowa instituted a statewide database and is currently running into problems because facilities will not report open beds.

Natalie Shea, the Emergency Service Manager at Central Community Hospital in Iowa says that the problem of open beds is unique to the mental health community because of the way that treatment is handled.

“The timely care of the patient by trainemergency_roomed staff and facility is so key to the success of treatment for these patients and we have not solved that issue at all,” Shea reports, “We need more access closer to the patient’s home.”

Delays in treatment have been shown to negatively impact the recovery of mental health patients who are in crisis. So much so, that HMO giant, Kaiser Permanente, has been fined millions in damages by the State of California for delaying the treatment of hundreds of patients. Kaiser Permanente has made improvements in staffing and other resources to address these concerns, but California recognizes the importance of prompt treatment.

US Congressman, Tim Murphey-R. from Greensburg chaired a committee that was tasked with dealing with the bed shortage issue across the states.

“We have replaced the hospital bed with the jail cell, the homeless shelter and the coffin,” he said, “How is that compassionate?”

How long must our psychiatric patients be kept waiting?

 

Sources:

Jordan, E. (2015, September 25). Iowa’s mental health bed-tracking database ‘not useful’ so far, hospitals say. Retrieved January 27, 2016, from http://www.thegazette.com/subject/news/government/iowas-mental-health-bed-tracking-database-not-useful-so-far-hospitals-say-20150925

Khimm, S. (2013, December 02). Not enough beds for the mentally ill. Retrieved January 27, 2016, from http://www.msnbc.com/all/no-beds-the-mentally-ill

McLeod, B. (2014, January 16). Statement: National Emergency Care Report Card Shows Need for Better Pennsylvania Effort on Psychiatric Bed Shortage. Retrieved January 27, 2016, from http://www.pamedsoc.
org/FunctionalCategories/About/Media/Psychiatric-Bed-Shortage.html

Olson, J. (2015, November 2). Shortage of state psychiatric beds leaves local hospitals jammed. Retrieved January 27, 2016, from http://www.startribune.com/shortage-of-state-psychiatric-beds-jams-twin-cities-hospitals/339185701/

Pfiefer, S., & Terhune, C. (2015, February 24). State again faults Kaiser Permanente for mental health treatment delays. Retrieved January 27, 2016, from http://www.latimes.com/business/la-fi-state-faults-hmo-giant-kaiser-permanente-mental-health-care-story.html

Psychiatric bed shortage stressing ERs. (2013, October 28). Retrieved January 27, 2016, from http://www.sciencedaily.com/releases/2013/10/131028100857.htm

Smydo, J. (2016, January 25). Finding beds for Pennsylvania’s mentally ill difficult even when available. Retrieved January 27, 2016, from http://www.post-gazette.com/news/health/2016/01/25/Finding-beds-for-Pennsylvania-mentally-ill-difficult-even-when-available/stories/201601170009

Stazbo, L. (2015, April 12). Cost of not caring: Nowhere to go. Retrieved January 27, 2016, from http://www.usatoday.com/story/news/nation/2014/05/12/mental-health-system-crisis/7746535/

Image from CBS Local and WPNR

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s