The Decline of Mental Hospitals

Treatment Advocacy Center has a new paper out about how state mental hospitals are in serious decline:

In “No Room at the Inn: Trends and Consequences of Closing Public Psychiatric Hospitals,” we use data from the National Association of State Mental Health Program Directors Research Institute to report changes in the availability of public psychiatric hospital beds from 2005 to 2010 and to assess the consequences for individuals and society. In summary:
Trends

• The number of state psychiatric beds decreased by 14% from 2005 to 2010.
 In 2005, there were 50,509 state psychiatric beds available nationwide. By 2010, the number had shrunk to 43,318.

• Per capita state psychiatric bed population by 2010 plunged to 1850 levels.
 In 1850, at the beginning of the movement to provide more humane care by treating seriously mentally ill persons in hospitals, there were 14 beds per 100,000 population. In 2010, the supply was virtually identical at 14.1.

• Thirteen states closed 25% or more of their total state hospital beds from 2005 to 2010.
 New Mexico and Minnesota closed more than 50% of their beds; Michigan and North Carolina closed just less than 50%. Ten states increased their total hospital beds but continued to provide less than half the beds.

• The decrease in state psychiatric bed availability since 2005 is actually worse than the 14% that occurred 2005-2010.
 Completed or announced bed eliminations since 2010 will eliminate 4,471 additional beds.

Overall, many states appear to be effectively terminating a public psychiatric treatment system that has existed for nearly two centuries. The system was originally created to protect both the patients and the public, and its termination is taking place with little regard for the consequences to either group.

They indicate that the per capita state mental hospital capacity is now where it was in the 1850s.  Even if antipsychotic medicines worked perfectly, and even if there was no problem with mentally ill persons refusing to take those medicines, this would be a perfectly peculiar situation.  State mental hospitals in the 1850s were already crowded.  As the mass murder problem that has developed in the last 30 years demonstrates, we need more capacity than we currently have.