Mixed messages on the advocacy front | Behavioral Healthcare Executive Skip to content Skip to navigation

Mixed messages on the advocacy front

April 11, 2008
by Ann Borders
| Reprints

The Treatment Advocacy Center has published on its website (www.treatmentadvocacycenter.org) a report by E. Fuller Torrey MD et al. entitled, "The Shortage of Public Hospital Beds for the Mentally Ill." The study indicates a critical bed shortage in 11 states; a severe shortage in 21 states; and a serious bed shortage in 16 states. South Dakota had a marginal shortage, and only Mississippi was viewed as meeting minimal standards (50 beds minimum per 100,000). Frankly, I would rather see the focus of attention on the part of these prominent researchers be on whether there are adequate community-based services in the states-- services that reduce the need for institutionalization. Granted, the authors include expansion of Assertive Community Treatment and Assisted Outpatient Treatment among their six recommendations. But, those who read such studies and are in a position to influence public opinion and public policy (read that the media) immediately leap to the conclusion that more beds are the answer. Truth is, I don't believe we know how many beds are needed until we formulate a minimum standard for community based services. In my state of Indiana (ranked among those with a severe bed shortage), we pay the price for the lack of public psychiatric beds-- even paying out of pocket for private hospital bed stays while consumers wait for weeks until state beds become free. There is limited support for ACT services, and none for Assisted Outpatient Treatment. I think that most providers and advocates would say that they'd far prefer that additional funding be directed to community-based care rather than state hospitals. A moot point, of course, since additional funds in either direction are about as likely as an Indiana Spring without tornados!



An excellent point, Ann. At the same time, though, do you think that the dearth of inpatient beds needs to be urgently addressed, especially as nonpsychiatric populations (e.g., sex offenders) take up already scarce beds? I suppose what we really need is a comprehensive plan that takes into account all aspects of the care continuum.

Right on the head, Doug. A comprehensive plan would be the ideal situation if only these matters were higher on the public policy priority list. In our state, providers are allocated a certain number of state hospital beds. However, all bets are off if the corrections system needs them. Prisons trump the providers and they get these beds for free while the mental health center pays for inpatient care in a private hospital until a bed comes available. As they say, there ain't no justice!

Ann Borders

President and CEO, Cummins Behavioral Health Systems, Inc


Ann Borders is president and CEO of Cummins Behavioral Health Systems, Inc., serving eight...

The opinions expressed by Behavioral Healthcare Executive bloggers and those providing comments are theirs alone and are not meant to reflect the opinions of the publication.