Closing state hospitals doesn't eliminate need for care

The use of general hospitals to treat serious mental illnesses increased 34.7% between 1995 and 2002 according to a new study published in Psychiatric services this month. This raises a number of questions, not the least of which is whether psychiatric units in general hospitals are equipped to provide the kind of treatment, rehabilitation and discharge planning that state psychiatric hospitals can provide.

Take Virginia for instance. In 2006, the average length of stay for acute admissions to a state psychiatric hospital was 47.2 days compared to 5.4 days in community psychiatric inpatients beds. The abbreviated treatment provided in general hospital psychiatric beds may account for these hospitals’ “revolving doors” through which 3,514 patients passed 3 or more times in 2002 at a cost of about $111 million. Maybe closing state psychiatric hospital isn’t such a good thing – for patients or budgets.

Analysis of U.S. Trends in Discharges From General Hospitals for Episodes of Serious Mental Illness, 1995–2002, Shinobu Watanabe-Galloway, Ph.D. and Wanqing Zhang, M.D., M.Ed., Psychiatr Serv 58:496-502, April 2007