A new report released today by the Treatment Advocacy Center reveals that for every 20 public psychiatric beds available in the US in 1955, only 1 such bed existed in 2005.

According to 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 17 per 100,000 persons. Mississippi had the most beds available in 2005 (49.7 per 100,000 people), while Nevada (5.1) and Arizona (5.9) had the least.

"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 mental
illness. Untreated persons with severe mental illnesses have become major problems in homeless shelters, jails, and emergency rooms and are responsible
for at least 5 percent of all homicides."

To determine a minimum number of beds needed, a consensus of experts looked at specific criteria such as number of individuals who need hospitalization, length of hospital stay, and current state and federal financing structures. Using these criteria, the panel concluded 50 public psychiatric beds per
100,000 individuals is the minimum required to meet current needs.

"This report confirms what many already know - too many people with severe mental illnesses aren't getting treatment," said report co-author, Dr. Jeffery Geller. "Someone with schizophrenia who is having a psychotic break should not be told they can't get treatment. We are talking about people in need of immediate care."

State Rankings

States with the fewest beds in 2005 were: Nevada (5.1 beds per 100,000 people), Arizona (5.9), Arkansas (6.7), Iowa (8.1), Vermont (8.9) and Michigan (9.9). States with the most beds available were South Dakota (40.3) and Mississippi (49.7).

"One silver lining in this alarming study is Mississippi meets the 50 bed standard," said study co-author and Treatment Advocacy Center executive director, Kurt Entsminger. "If the state which ranks 49 in per capita income can achieve the minimum standard, then states with greater wealth have no
excuse for failing."

Consequences of Bed Shortage

The consequences of the reduction in psychiatric hospital beds are evidenced in the following areas:

-- Homelessness.  A study in Massachusetts found 27 percent of patients discharged from a state psychiatric hospital became homeless within six months; a similar study in Ohio showed 36 percent.

-- Jails and Prisons as Psychiatric Hospitals.  Since the reduction in public psychiatric beds there has been an increase in severely mentally persons in jails and prisons. Conservative estimates say 7 to 10 percent of all inmates have a mental illness, while some studies show 20 percent or higher.

-- Hospital Emergency Room Overflow.  Emergency rooms are often used as waiting rooms for psychiatric beds, thus backing up the entire hospital system and compromising other medical care. In Arlington, Virginia, county officials had to call 31 hospitals before finding one that would accept a patient.

-- Violent Crime.  Studies show 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.

Recommendations

The severe shortage of public psychiatric beds should not be tolerated and can be ameliorated in a number of ways:

-- Holding state governors and mental health officials responsible for the shortage.
-- Utilizing Programs of Assertive Community Treatment (PACT) and assisted outpatient treatment (AOT), both of which have been proven to decrease hospitalization.
-- Modifying federal and state regulations to allow the utilization of alternatives to psychiatric hospitalization.