Posted by baseball55 on January 17, 2014, at 19:56:58
In reply to Re: state hospitals v.s regular psychatic hospials » Lamdage, posted by Phillipa on January 17, 2014, at 18:04:03
Most of the public psychiatric hospitals were closed in the 1980s. Massachusetts has only two still open - one for the criminally insane. When the hospitals were closed, the idea was that patients would be transferred to small-group, community care facilities -- we're not talking about people in acute crisis here, but about people with chronic, disabling mental illnesses like schizophrenia.
Unfortunately, the community care programs were never funded. So patients ended up on the streets or in prisons. According to a series of articles a while back in the NYTimes, American prisons are now the major caretakers for the severely mentally ill in the US.
Acute care is also lacking. Low reimbursement rates have caused many non-profit hospitals to reduce the number of inpatient acute care beds for mental illness. The US also has a number of for-profit acute care psychiatric hospitals. I was in a couple. They are awful. No staff, no groups. I have been hospitalized several times in the Boston area. It is not unusual for patients to wait (under constant observation, since acute care is not covered by insurance unless the patient is in danger) entire weekends in the emergency room due to a lack of beds. There are not nearly enough acute care psychiatric beds in the US.
Chronic care beds -- forget it. They barely exist anymore, unless you consider locking up a homeless schizophrenic in prison to be a chronic care bed.
poster:baseball55
thread:1058688
URL: http://www.dr-bob.org/babble/20140104/msgs/1058839.html