How The Loss Of U.S. Psychiatric Hospitals Led To A Mental Health Crisis

November 30, 20171:15 PM ET
SAMANTHA RAPHELSON

A severe shortage of inpatient care for people with mental illness is amounting to a public health crisis, as the number of individuals struggling with a range of psychiatric problems continues to rise.

The revelation that the gunman in the Sutherland Springs, Texas, church shooting escaped from a psychiatric hospital in 2012 is renewing concerns about the state of mental health care in this country. A study published in the journal Psychiatric Services estimates 3.4 percent of Americans — more than 8 million people — suffer from serious psychological problems.

The disappearance of long-term-care facilities and psychiatric beds has escalated over the past decade, sparked by a trend toward deinstitutionalization of psychiatric patients in the 1950s and '60s, says Dominic Sisti, director of the Scattergood Program for Applied Ethics of Behavioral Health Care at the University of Pennsylvania.

"State hospitals began to realize that individuals who were there probably could do well in the community," he tells Here & Now's Jeremy Hobson. "It was well-intended, but what I believe happened over the past 50 years is that there's been such an evaporation of psychiatric therapeutic spaces that now we lack a sufficient number of psychiatric beds."

A concerted effort to grow community-based care options that were less restrictive grew out of the civil rights movement and a series of scandals due to the lack of oversight in psychiatric care, Sisti says. While those efforts have been successful for many, a significant group of people who require structured inpatient care can't get it, often because of funding issues.

A 2012 report by the Treatment Advocacy Center, a nonprofit organization that works to remove treatment barriers for people with mental illness, found the number of psychiatric beds decreased by 14 percent from 2005 to 2010. That year, there were 50,509 state psychiatric beds, meaning there were only 14 beds available per 100,000 people.

"Many times individuals who really do require intensive psychiatric care find themselves homeless or more and more in prison," Sisti says. "Much of our mental health care now for individuals with serious mental illness has been shifted to correctional facilities."

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https://www.npr.org/2017/11/30/567477160/how-the-loss-of-u-s-psychiatric-hospitals-led-to-a-mental-health-crisis