[Enews] Press Release on Reinvestment

[NAMI-NYS Enews]

February 5, 2007

For Immediate Release

Contact: J. David Seay, Executive Director, 800-950-3228

 

Do Reinvestment Right: Put More Beds in Fewer Buildings

 According to the Office of Mental Health's budget overview, OMH will be "seeking out opportunities to eliminate unnecessary state inpatient capacity." According to the agency's 2006 Statewide Comprehensive Plan for Mental Health Services, there is no unnecessary state inpatient capacity.

On page 72 of the Comprehensive Plan, OMH states the following: "The ability to further close or consolidate state psychiatric center inpatient capacity does not appear warranted at this time due to the leveling off of previously declining demand for inpatient services, utilization of current inpatient capacity, and the need to evaluate future inpatient capacity requirements."

This is a tremendous understatement. The truth is that those who need this level of care are being turned away on a routine basis. The City of New York's 2006 Local Governmental Plan for Mental Health Services reported waiting periods as long as 200-300 days for patients to be admitted into state psychiatric hospitals. Mental health care consumers and their families have reported long waiting periods throughout the state. 

Nationally recognized expert opinion recommends that about two percent of adult individuals with serious mental illness need long-term or intermediate care.  In New York State, there are approximately 390,000 adults living with serious and persistent mental illness (SPMI), this translates into 7,800 people in need of such care. Currently there are 4,030 adult care beds in the system. The disparity between the beds we now have and the number we should have is even worse for children and individuals who have a dual diagnosis of a serious mental illness and chemical dependency.

The point is that actual need exceeds available resources. The bottom line is we need more beds, not fewer. What's at stake is the integrity of the entire mental health system as well as the lives of countless individuals. Many improvements have been made in outpatient services, but even the best of outpatient programs cannot substitute for inpatient stabilization, which is what the intensive therapy in these hospitals provides. Without effective stabilization, individuals cannot successfully participate in community services designed to help them recover, and they often get stuck on our streets, in our jails and prisons and in the revolving door of our acute care wards. Even Assisted Outpatient Treatment and Assertive Community Treatment can have little or no success with individuals who are not stable enough to take the next step.

 Seeking to eliminate unnecessary capacity will not save the state any money because, again, there is no unnecessary capacity left in the system. If the state were to focus on the capacity that it has already eliminated, however, it could garner significant savings. According to OMH, the average number of beds in an adult psychiatric center has declined from 5,200 to 250. The state is spending a lot of money to maintain large buildings for a relatively few beds. That's the problem.  In this case, right-sizing means more contents in smaller containers.

We could support hospital consolidations if they were done right, with the tradeoff being an actual increase in total beds for persons with serious mental illness -- not violent sexual predators -- more community services such as Assertive Community Treatment teams, and creative ways to deal with the gap in intermediate care in the service areas where hospitals are closed, such as having intermediate care wards in Article 28 hospitals with a shared staffing arrangement.

As an organization consisting of family members and consumers, we are heartened by OMH's statement that "right-sizing" the state psychiatric hospital system will require the full cooperation of all key stakeholders, most importantly the patients and their families, and we are ready  to play a constructive role in making this a more effective as well as a more efficient system.  The problem is not simple, and it requires is a deliberate, thoughtful and comprehensive approach. Rushing to get on the reinvestment bandwagon without such an approach could make things much worse for people with serious mental illness in New York State.

 

NAMI - New York State is a 25-year-old grassroots, nonprofit membership organization for New Yorkers with serious mental illness and their families, with thousands of members in 60 community affiliate organizations statewide.

 

 

 

 
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