Decline in psychiatric hospital beds concerns Sonoma County Jail officials

The Sonoma County Main Adult Detention Facility in Santa Rosa in 2015. (BETH SCHLANKER/ PD FILE)


The number of state psychiatric hospital beds continues to decline across the country, a disturbing trend that is being felt at the local level, especially by mentally ill patients in jail, Sonoma County officials said last week.

In the past five years, 20 percent of the nation’s state hospital beds for the country’s most disabled and dangerous psychiatric patients have disappeared, according to a report by the Treatment Advocacy Center, a Virginia-based national nonprofit that works to eliminate barriers to treatment for people with severe mental illness.

“We’re seeing that the situation regarding state hospital beds has reached an unimaginable crisis,” said John Snook, the organization’s executive director.

“We’re now seeing far fewer beds than would even be considered the bare minimum.”

The report did find that there was an increase in the number of psychiatric inpatient beds in California, from 5,283 in 2010 to 5,905 in 2016.

However, that increase becomes less significant when taking into account the increase in the state’s population and, more importantly, the dramatic decline in the number of hospital beds for more than a decade before 2010.

The decline in such beds has resulted in local jail inmates with severe mental illness having to wait many months to be transferred to a state facility for intensive mental health treatment. State hospitals are the equivalent of intensive care units in general hospitals.

“It takes anywhere from six to eight months to get them into a state hospital bed,” said Michael Kennedy, director of Sonoma County’s mental health department.

“That has a huge impact on folks that need to get out of jails to get into a state hospital.”

Assistant Sonoma County Sheriff Randall Walker, who oversees the county jail system, said the bump in the number of California beds is a good sign, but it’s not having much of an impact locally.

“It still takes approximately 90 days from when the court orders placement in a state hospital to when the hospital can receive the inmate,” Walker said. “Ninety days is still not an acceptable amount of time to await treatment in a hospital setting.”

Walker said he understands the budget constraints at the state level, where lawmakers must balance other community needs such as schools, roads and clean water with the need for more psychiatric beds.

In the 1960s, a move known as “deinstitutionalization” began to empty out state-run psychiatric hospitals. During that period, new California laws both defunded mental health hospitals and restricted involuntary hospitalizations. The trend continued for decades, and some researchers claim the shortage of psychiatric beds has led to more homeless people on the streets, greater incarceration of mental health patients and a growing burden on medical hospitals.

Snook said local jails are increasingly picking up the slack as the number of state-run hospital beds continues to decline.

That number has dramatically decreased since the mid-1950s. The Treatment Advocacy Center’s report found that only 3.5 percent of the state hospital beds that existed in 1955 were still in operation by the first quarter of 2016.

The report found that the state hospital bed ratio in some states has dropped to about three per 100,000. In California, the number is 15 per 100,000.

By comparison, the average number of psychiatric beds in the 34-nation Organization for Economic Cooperation and Development, or OECD, is 68 beds per 100,000 people.

The group includes the United State and other developed nations like Australia, Canada, Germany and the UK.

“What we’re talking about here is crisis care for the most severely ill,” Snook said.

The increase in beds in California was not enough to compensate for the loss over the past 20 years, he noted.

“I don’t think anyone would look to California and say there’s an adequate bed capacity,” Snook said.