Thursday, October 11, 2007

Virginia Report: Not Enough Psychiatrists, Beds

The Washington Post reports today on a 230-page state report that finds Virginia "lacks experienced psychiatrists to evaluate the mentally ill, there aren't enough beds for those seeking emergency treatment in many areas and hospitals are losing money on mentally ill patients, according to a state government report."

Last year, NAMI released a Report Card for each state, grading them on things like access to care, services, and infrastructure. Virginia received a grade of D. Today's report suggests increasing funding to meet the state's need.
"Additional psychiatric beds cannot be opened unless there are psychiatrists available and willing to staff them," the report says. It adds: "On the outpatient side . . . a lack of psychiatrists affects licensed hospitals because individuals in need of psychiatric service cannot find them in the community and . . . turn to emergency departments. . .

To address these shortfalls, the report suggests that the state "examine its potential role in . . . assuring an adequate supply of beds . . . [by] increasing financial support for uninsured psychiatric patients.
NAMI's report noted the lack of culturally competent treatment, and rights abuses in some of the state hospitals.

"Additionally, Virginia's ability to serve its growing population of ethnic and racial minorities has suffered because the state has shown no initiative on the issueof cultural competency. Virginia has not conducted a cultural competency assessment or developed a plan to meet the needs of minorities, who comprise nearly 30 percent of the state's total population.

Lack of short-term acute care beds for individuals in crisis is another major problem. In Northern Virginia, the commonwealth's most populous area, approximately 24 percent of the region's private bed capacity vanished in 2005 alone, due mostly to the closure of psychiatric wards at four different hospitals. Individuals in need of beds are transported downstate, resulting in trauma for the individual and diversion of local police officers, who must spend hours transporting people to areas as far away as Hampton Roads.

State hospitals have posed a different set of issues. In the 1990s, four out of 10 were under investigation by the U.S, Department of Justice (DOJ) for egregious violations of the rights of patients."
To view the actual report, the 230-page pdf report is here, and the briefing, consisting of 60 slides, is here.


The Shrink said...

Beds ain't the whole answer, though. Great community services can (and often do) result in low in-patient beds. Home treatment teams, assertive outreach teams, early intervention teams, crisis resolution teams and community mental health teams all can deliver better mental health care in the really real world (rather than the sanctuary of a hospital in-patient unit). When psychotic patients can usually be successfully managed in the community by such teams, what do you truly need an in-patient bed for? It can be possible to have a great service with very few admissions and low reliance on a large bed base. Most psychiatric activity can happen in the community.

But although I wanted to make the point that community psychiatry can give great results with a low bed base, since the rest of the community infrastructure scores so badly, sadly it seems that mental health services as a whole are underresourced.

Ho hum.

Anonymous said...

I live in Washington, DC - which is basically Virginia. This explains a lot of the craziness going on here... :)

Anonymous said...

to the last commenter: Ah, what exactly do you mean by the "major ladies disease" that you have on one of your zillion blogs? Would these be diseases that might afflict Hillary, or the
Queen of England, or Joan of Arc? I mean, they are/were all major ladies. Can minor ladies have diseases too? Is it like the Oscars, with best actress and best supporting actress? Is it baseball with major and minor leagues? Oops forgot that is the domain of men. If you are not a lady but do happen to be of the female gender, is it possible to have those diseases? If not, then I think a major prevention campaign is in order. From now on we must encourage women to be less ladylike. I feel very sorry for Laura B. because she is the first lady and must have a lot of those diseases(but also because she is married to such a schm...)

Roy said...

the shrink, no argument here. Money spent on community services would save a lot more money downstream. Stitch in time, and all that.

Unfortunately, it looks like a lot of the community services were cut in the 90's, laying the groundwork for the current undersupply of beds due to inadequate community supports.

::big sigh::

tracy said...

i can personally vouche for the problems here.