California Healthline Daily Edition

Summaries of health policy coverage from major news organizations

Treatment of Patients in Psychiatric Hospitals Down, Report Finds

In 2010, California hospitals served 16% fewer patients with mental illnesses than state hospitals did in 2005, according to a report released Thursday by the Treatment Advocacy Center, the Los Angeles Times reports.


In 1999, the U.S. Supreme Court ruled that public entities must administer psychiatric services and programs in the "most integrated setting appropriate." The ruling also applied to people with developmental disabilities.

According to the Times, the ruling encouraged a trend of deinstitutionalizing patients who were not under the jurisdiction of criminal courts.

Doris Fuller -- executive director of the Treatment Advocacy Center -- said that although the ruling clearly stated that hospitals should not be forced to release patients too ill to care for themselves, it "has widely been used mistakenly as a justification to do just that."

U.S. Findings

According to the report, the number of state hospital psychiatric beds nationwide decreased by 14% from 2005 to 2010, forcing individuals with mental illnesses into emergency departments, jails and prisons.

The report states that "95% of the nation's public psychiatric hospital beds (have) disappeared," while "community psychiatric care exists for fewer than half the patients who do need it."

California Findings

The report found that California hospitals served 5,283 patients in 2010.

According to the report, about 92% of psychiatric beds in the state now are occupied by patients from the criminal justice system.

Researchers did not study the availability of psychiatric beds for acutely ill patients in county or privately run facilities. The California Hospital Association said that the number of psychiatric beds decreased by 30% between 1995 and 2010.

Report Recommendations

The report encouraged states to treat patients with mental illnesses in community facilities whenever possible, rather than institutionalizing them. It called on states to stop reducing the number of psychiatric hospital beds until there are enough alternatives available at community facilities.

It also recommended that states:

  • Increase the use of court-ordered outpatient treatment for patients who are too sick to seek help; and
  • Boost Medicaid coverage for psychiatric patients in state hospitals (Romney, Los Angeles Times, 7/20).
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