Tuesday, January 23, 2007

Hospitals are victims as much as villians

A series from the Atlanta Journal Constitution earlier this month focused on at least 115 suspicious deaths of patients in Georgia’s seven psychiatric hospitals and more than 190 cases of physical or sexual abuse. The series also documents violence against hospital employees and ties much of the horrors back to gross understaffing and underfunding of these institutions.

There are calls for a legislative commission – and NAMI wants the U.S. Justice Department to launch an investigation.

For decades there has been a widespread and concerted effort to close down hospitals and move patients into community treatment. Community providers take the money that comes with such a shift with ease, but then balk at performing some of the more critical hospital functions, including involuntary treatment. At the same time, there is little realization that some people need intensive inpatient care – and for those people, the cry should be not to kick them out of the hospitals, but to make the hospitals better. The result is that some of the sickest people are left behind, because neither the much-touted community services or the outdated and underfunded hospitals can address their very real and immediate treatment needs.

Horrors like those listed in the AJC stories are eye-opening and terrifying – but the hospitals did not end up underfunded and understaffed by their own choosing. As Dr. Jeffrey Geller says in the series:

"Ultimately, do the taxpayers want to do what's needed to be done in their state hospitals, or not?" says Dr. Jeffrey Geller, director of public sector psychiatry at the University of Massachusetts Medical School.

"It's too simplistic to make the state hospital the isolated villain," he says. "The state hospital is as much a victim as a villain — a victim of inadequate funding, a victim of the general population of the state not caring enough about its most unfortunate and disenfranchised, a victim of ineffective utilization of resources that do exist."

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