Byline: Susan Abram
Staff Writer
SHERMAN OAKS -- The number of psychiatric beds in public hospitals has fallen dramatically across California and the nation -- with the Golden State now dedicating just 17 beds for mentally ill patients for every 100,000 residents, according to a newly released report.
While the ratio in California mirrors the national average, it represents a sharp drop over the past five decades -- from 340 beds per 100,000 people nationwide in 1955, according to the report by the national nonprofit Treatment Advocacy Center.
'The results of this report are dire and the failure to provide care for the most seriously mentally ill individuals is disgraceful,' said Dr. E. Fuller Torrey, president of the Arlington, Va.-based center that advocates for treatment of the mentally ill.
'Our communities are paying a high price for our failure to treat those with severe and persistent mental illness, and those not receiving treatment are suffering severely.'
Researchers with the center are urging at least 12,200 beds be added across California, nearly double the 6,285 beds that were counted in 2005.
In Los Angeles County, health officials said 140 beds are spread throughout the public hospital system and there are another 222 beds at Metropolitan State Hospital in Norwalk. County officials also note more beds are available in private hospitals, nursing homes and group homes.
But the Los Angeles Police Department and the Los Angeles County Sheriff's Department say they've become a de facto safety net for mental health services because there is no room at the hospitals.
At the county's Twin Towers jails, 1,000 beds are filled nearly every night by psychiatric patients -- more than in any mental institution west of the Mississippi, according to the LAPD.
And of the nearly 20,000 inmates in the county's jail system, about 60 percent suffer from mental illnesses, according to a recent report by the Washington, D.C.-based Justice Policy Institute.
Meanwhile, incidents involving the mentally ill have surfaced on L.A.'s streets. In one case last year, the mother of a mentally disturbed 23-year-old who was shot by police after he ran over a pedestrian said that hours before he was killed, she pleaded with the LAPD to apprehend her son.
Luis Salinas, who battled mental illness, had been taken to a mental facility weeks before, where he had been evaluated and released 48 hours later. Doctors there said he was suffering from a brief psychotic disorder.
The '5150' patient
Emergency rooms also are scrambling to meet the needs.
'We have acute and chronic demand for what we call the '5150' patient -- or those who are hospitalized without their consent,' said Jim Lott, executive vice president of the Southern California Hospital Association. 'These patients are very hard to find beds for and are clogging up hospital emergency rooms.'
Fueling the issue, Gov. Arnold Schwarzenegger signed an overdue state budget last summer that included slashing $55 million for housing the homeless mentally ill.
'There has been no word or movement on the issue (of more beds) from anyone in the state,' Lott said.
Medicare rates also affect behavioral health units at private community hospitals that rely on the government reimbursements.
On Friday, Los Robles Hospital & Medical Center in Thousand Oaks closed its 16-bed mental health unit for seniors because of declining reimbursements, according to published reports.
The average cost to hospitals to treat those with severe mental illness is about $800 a day, Lott said. But for homeless or Medicare patients, hospitals receive $475 from the state and the county. Without that money, many of the units have been shuttered, he said.
The decline in the number of beds for mentally ill patients also comes amid an overhaul of state mental institutions -- stand-alone facilities that started closing during the Reagan administration.
'Over the last decade, we have cut many beds from state hospitals as we've developed more in community settings,' said Dr. Roderick Shaner, medical director for the Los Angeles County Department of Mental Health.
'The bottom line is we need every kind of service but we can't use models of a half-century ago.'
The solution falls on community hospitals and organizations that can likely secure federal funding for more beds -- something state hospitals are unable to do, Shaner said.
'I think that in the longer term, we are developing new resources ... that will allow us to support the people in the community,' Shaner said. 'However, there is a problem with getting access to emergency psychiatric hospitalization in the short run.'
Jonathan Stanley, deputy executive director for the Treatment Advocacy Center, said that while attitudes and treatment toward the mentally ill have improved, the bed shortage means hospitals are slashing the amount of time for treatment.
'I think the average stay in a psychiatric hospital now is seven days to help them get stabilized with their meds,' Stanley said. 'But the problem is they are not staying long enough and they are still systematic when they leave. They end up coming back or going to jail.'
Bucking the trend
Some San Fernando Valley facilities are trying to buck the trend, especially for the elderly with mental health issues, including depression and early signs of dementia.
Sherman Oaks Hospital is hoping to add 19 beds for those 55 years and older with mental health issues.
The hospital had shut down its behavioral health unit -- which served those who were involuntarily admitted -- in 2006 because it never reached capacity.
The new facility is for voluntary patients and aimed at treating seniors with a full spectrum of mental illness.
Experts said the need could be great, as 79 million baby boomers are aging and some might have received inconsistent treatment in their youth, resulting in what could be a wave of mental health needs.
'We're looking at the backlash of the Reagan movement. These people were in their 20s and 30s and are now in their geriatric situations,' said Tricia Devon, director of psychiatric services at Sherman Oaks Hospital. 'We need to find a different way to treat patients. There's too many people in the streets.'
The Jewish Home for the Aging in Reseda also has opened a 10-bed behavioral unit.
'We saw there was a need for this, with our own residents here at the home,' said Gay Howard, who heads the unit. 'A lot of these patients were identified for behavioral therapy, but they didn't want to leave because this is their home.'
The average amount of stay in the new unit is about 10 days, Howard said, and treatment includes activities and therapy.
'We are dealing with people who come from an era where they didn't talk about their problems,' she said. As a result 'they don't receive the proper diagnosis and no one then knows they are depressed.
'We want to tell them it's OK to ask for help.'
susan.abram(at)dailynews.com
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