(Apr. 22, 2016) Pam Lipp discovered how difficult it is to find an available inpatient psychiatric bed in the state of California when her 18-year-old daughter, Amanda, suffered a psychotic episode in 2010.
Amanda had been admitted to a psychiatric crisis center but she could only stay there for 72 hours. Lipp asked the crisis center for help finding her daughter a bed in a facility that could provide longer-term care, but was told she was on her own – a problem many families in California and across the country face due to a scarcity of beds and inconsistent reporting of openings (“A dearth of hospital beds for patients in psychiatric crisis,” Kaiser Health News, Apr. 12).
Lipp called one hospital after the next only to find that they were all full. After eight hours, she finally found her daughter an open bed in Fair Oaks, California. She was lucky: many psychiatric patients spend days deteriorating in hospital emergency departments while they wait for a bed.
And it’s no wonder: California is facing a serious shortage of psychiatric beds, said Randall Hagar, director of government affairs for the California Psychiatric Association. The state eliminated 16 percent of its beds between 2005 and 2010, according to a 2012 Treatment Advocacy Center report, leaving just 14.2 public psychiatric beds per 100,000 people – far below the 50-bed standard considered necessary to provide minimally adequate mental health treatment. In 25 counties in the state, there were no psychiatric beds at all.
“We have to use the beds we do have and we have to know where they are. It can be a hit or miss process. It needs to be more reliable,” said Hagar. “We’ve heard instances where people were told there were no beds when in fact it turns out later that there were. An online registry would fix that issue.”
AB2743, an Assembly bill backed by the California Psychiatric Association, seeks to address this problem by establishing an online registry to collect and display information that would help find psychiatric beds. Facilities with psychiatric beds would be required to update the registry as the beds became available, and emergency medical providers would be able to use it to search for openings.
But the California Hospital Association is firmly opposed, saying that finding the right placement for a patient is much more complex than identifying an empty bed.
Part of the problem is the national shortage of psychiatric beds, in part due to the IMD exclusion. One necessary fix is the IMD exclusion. Eliminating the IMD exclusion would increase the availability of psychiatric beds, increase access and decrease psychiatric boarding issues for people with severe mental illness.
Pam Lipp said an online bed registry is an “absolutely phenomenal” idea.
“If I hadn’t done what I did, our daughter would most likely have been discharged, back on the street with nowhere to go, and we would have just repeated the cycle again,” said Lipp. “Maybe she wouldn’t have survived.”
Visit #aBedInstead to learn about the Treatment Advocacy Center's new campaign to address the national psychiatric bed shortage.
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