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Shortness of Mental Hospital Beds February 3, 2010

Posted by Crazy Mermaid in Mental Hospital, mental illness.
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Society seems to think that if we eliminate the places people can go for help managing their mental illness, then we can eliminate the illnesses themselves.  We can say to ourselves “Look! The places we used to treat mental illnesses at are all gone!  That must be because there are no more mental illnesses requiring hospitalization! Yay!”

In 1973, Washington State shut down Northern State Hospital in Sedro Wooley, which is about an hour’s drive from Seattle, due to budget cuts.  Back in its heyday, Northern housed 2,700 patients.  Despite the substantial increase in population from 1973 to the present (almost 40 years), there has been no increase in the number of mental hospital beds. In fact, they keep decreasing.

Shutting down the facilities is society’s way of trying to make the problem go away.  If there’s nowhere to treat the problem then the problem must be gone.

It’s interesting to look at the presidential familial histories of the presidents in office when certain actions were taken regarding mental illness. For example, when John F Kennedy, whose sister was lobotomized, was in office in the early 1960’s, the secrecy of mental illness was blown wide open. Mental hospitals were built, programs for mentally ill were implemented, cruel practices like lobotomies were stopped, and mental illness finally came out of the deep recesses of the closet.

Then, when Ronald Reagan, a man with no public ties to mental health, took office in the 1980’s, politicians were looking to shrink government and reduce spending. With the advent of new medications, the people governing the nation got the (wrong) impression that mental hospitals were suddenly passé, no longer needed because new medication took the place of hospitalization. The general idea behind the shuttering was that the new drugs made hospitalization obsolete, and that those housed in the facilities were fairly long-term residents who would be better served outside the state-run hospitals rather than inside them.

The sad truth is vastly different. The true effect of this bed shrinkage is felt most clearly on two groups of people: those needing long-term care and those looking for short-term care . People seeking short-term care need specialized supervision and care in order to get their medications started or under control under strict medical supervision. They and their families suffer from the shortage of hospital beds.  They go untreated, unable to get to a place where they can manage their illness.

Those needing short-term care but not finding it soon turn into those needing long-term care. Unable to find long-term care either, they take to the streets. We know them as the homeless population.

The medical community acknowledges that there is a need for more beds, but the reality is that there is no movement afoot to do anything about it. Especially in this cash-strapped time, there is no room in our budgets for building new mental hospitals, despite our increased population. That’s sad.



1. lostinnotation - February 4, 2010

This is a really important issue. Are there any groups in America lobbying for more beds at the moment? The presidential issue was really interesting, I never knew that about JFK’s sister. What is strange is that when Thatcher came in in England she also shut down a ridiculous amount of wards. Do they do better home care in America as a result of these places shutting down or are people being left more dependent on the kindness of relatives and charitable organisations? Thanks for a good read.

Crazy Mermaid - February 4, 2010

No, there’s nobody lobbying for more beds that I’m aware of, unfortunately. And no, they don’t do better home care here. What happens is that they don’t get the help they need. The unmet short-term needs turn into unmet long-term need, and eventually quite a few of them end up homeless on the streets. A huge percentage of our homeless population is mentally ill. While I was hospitalized, at least 75 % of those in there with me were mentally ill.

2. Sheri - February 4, 2010

Many times I have had to wait more than 12 hours for an emergency room to find a bed somewhere for my daughter, and it usually ends up being a hospital that’s over an hour away. When I was younger, I had no problem with finding beds within a reasonable time and distance.

It’s so frustrating that nothing is being done about this. In the US, our care of those with a mental illness is appalling.

3. Astrid - February 5, 2010

Actually, the problem is not confined to the U.S., and may not be entirely politically motivated. In the Netherlands, the 1980s saw a large cut in mental hospital beds, too, along with fewer involuntary commitments. It may’ve been partly a political move, in that we too had budget cuts at the time, but it was also a philosophical move. “Rehabilitation” and the “recovery model”, you know?

4. Cherrie Herrin-Michehl, MA, LMHC - February 9, 2010

I find it very disturbing that although the population has grown so much, the number of hospital beds has stayed the same. Is NAMI or any other organization addressing this issue? Thanks, Cherrie

5. moodybpgirl - February 11, 2010

There’s definitely nothing being done on a national level in the US. I don’t know what it’s like from state to state.

“Not In My Backyard” is the phrase we use with regard to crisis beds. We fought for years to get a crisis center built in our county. People were rallying to stop it from opening; lawsuits were thrown around, etc. So many people are afraid their towns will be overrun with “the criminally insane” if they allow facilities to open up crisis beds in their area. We are *still* in litigation with the local hospital that has sued the county in order to get rid of its psychiatric emergency room. Unfortunately I’ve heard about this kind of thing happening all over.

Crazy Mermaid - February 11, 2010

That Time article I mentioned at the tail end of my blog, Senator Domaninci talks about building those 50/50 mental hospitals. I like his concept, and I admit I haven’t done any research into it to see if it ever got off the ground. There’s a blog in that topic for us. While I intend to do my own blog entry, I’d love to read whatever you find out/think about it.

moodybpgirl - February 14, 2010

I will definitely look into it and see what I can find. Right now I am between laptops so my response time is much slower than I would like!

6. Psychiatric Deinstitutionalization and the Premise of Cost-Effectiveness « Astrid's Journal - August 4, 2010

[…] state hospitals as a positive thing. On the same day, however, Crazy Mermaid commented on the shortage of psychiatric hospital beds as something negative. These are two rather opposite views on the very same issue: should we be […]

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