Subcommittee Hears from Range of Distinguished Witnesses Regarding Lack of Access to Psychiatric Beds for the Seriously Mentally Ill

March 26, 2014

Members, Witnesses Review Consequences of Limited Availability of Inpatient Psychiatric Care

WASHINGTON, DC – The Oversight and Investigations Subcommittee, chaired by Rep. Tim Murphy (R-PA), today held a hearing entitled “Where Have All the Patients Gone? Examining the Psychiatric Bed Shortage,” to discuss the lack of access to inpatient psychiatric beds for seriously mentally ill patients. Members heard from a panel of 10 witnesses with a variety of perspectives to discuss the effects this scarcity of care has on patients, hospitals, and the community at large.

Murphy explained, “Nationwide, we face an alarming shortage in inpatient psychiatric beds that, if not addressed, will result in more tragic outcomes. This is part of the long-term legacy of deinstitutionalization, the emptying out of state psychiatric hospitals resulting from the financial burden for community-based care being shifted from the state to the federal government. … The result is that individuals with serious mental illness who are unable to obtain treatment through ordinary means are now homeless or entangled in the criminal justice system, including being locked up in jails and prisons. Right now, the country’s three largest jail systems – in Cook County, Illinois; Los Angeles County; and New York City – have more than 11,000 prisoners receiving treatment on any given day and are, in fact, the largest mental health treatment facilities in the country. Not surprisingly, neither living on the streets nor being confined to a high-security cellblock are known to improve the chances that an individual’s serious mental illness will stabilize, let alone prepare them, where possible, for eventual reentry into the community, to find housing, jobs, and confidence for their future.”

Lisa Ashley, the mother of a son with a serious mental illness, shared her experiences with her son trying to seek care at emergency departments, which on more than one occasion left him waiting for treatment, in at least one case handcuffed to a bed. She testified, “I know I have no alternative but to bring him to the ED, knowing he will have a long stay, it upsets me, it shouldn’t be so hard to get the right care you need at the right time in the right place.”

Thomas J. Dart, a Sheriff in Cook County, Illinois, added, “On any given day, an average of 30-35% of the jail’s population suffers from a serious mental illness. … Every single day, I am faced with the mental health crisis in this county. I see the pain of those suffering from mental illness and the pain of their families who have struggled to care for them and provide them with resources. The question that plagues me – that keeps me up at night – is where do we go from here?”

Michael C. Biasotti, Chief of Police and Immediate Past President of the New York State Association of Chiefs of Police, and the parent of a daughter with a serious mental illness, spoke about a survey he published in 2011, “Management of the Severely Mentally Ill and its Effect on Homeland Security.” Biasotti said, “As an example, there are fewer than 100,000 mentally ill in psychiatric hospitals but over 300,000 in jails and prisons. The officers I surveyed pointed out the drain on resources it takes to investigate, arrest, fill out paperwork and participate in the trials of all of them. Add that to the sheriffs, district attorneys, judges, prisons, jails and correction officers it takes to manage each of them and you see the scope of the problem. Many more related incidents, like suicides, fights, and nuisance calls take police time, but don’t result in arrest or incarceration.”

Biasotti went on to say, “If I could make one recommendation, it would be to prevent individuals from deteriorating to the point where law enforcement becomes involved. Return care and treatment of the most seriously ill back to the mental health system. Make the seriously mentally ill first in line, rather than last. As a law enforcement officer and father, I know treatment before tragedy is better policy than tragedy before treatment.”

Hakeen Rahim, a mental health educator and advocate from New York, shared his own experience with his mental illness and the importance of accepting his illness and establishing a good treatment regimen in his road to recovery. Rahim said, “Mental illness is individual to each person. There are so many different diagnoses and each person, even with the same diagnosis, responds differently to the medication, responds differently to the knowledge that they may even have it, or even responds differently to their parents’ care and concern.” 

The witnesses today shared many powerful perspectives on the broad impacts the shortage of inpatient care has on our society. Understanding these impacts is an essential step in working to address this issue. Murphy, who is a clinical psychologist with thirty years experience, has been a leader in the effort to address the nation’s broken mental health system and introduced the Helping Families in Mental Health Crisis Act, H.R. 3717, last December following an extensive investigation.

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