Inpatient psychiatric care–Updated: 1/3/14

 Action item:

  • Support Senate Bill 822 (Hastings) which will require that the proceeds of the sale of the land underneath any state hospital which is closed be invested in community mental health services.

Background

  • Like most states, the number of inpatient psychiatric beds in Illinois has declined by more than 90% since its peak.  In the 1950s there were 35,000 state-operated psychiatric beds.  In 2014, there are only 1,200 despite the fact that our population has almost doubled.
  • In 2012 Illinois closed two of the nine remaining state operated hospitals:  Tinley Park Mental Health Center in Chicago’s south suburbs and Singer Mental Health Center in Rockford.  There are seven remaining state-operated mental health facilities:  Read MHC (on Chicago’s northwest side), Madden MHC (in the western suburbs of Chicago), Elgin MHC (in the far northwest suburbs), McFarland MHC (in Springfield), Chester MHC (in far southern Illinois), Choate MHC (near St. Louis) and Alton MHC (also near St. Louis).
  • The number of private inpatient beds has also declined with many general hospitals closing their psychiatric units.  Currently there are approximately 3,000 private beds.
  • Many factors have contributed to the reduction in the number of inpatient beds.  They include:  the development of effective psychotropic medications, the increased cost of operating psychiatric hospitals due to improvements in staffing levels, enhanced compensation of employees and other quality of care improvement, the Federal government’s decision not to fund stand-alone psychiatric hospitals under the Medicaid program (the so-called “IMD” exclusion),  improvements in community care, heightened procedural protections for persons facing involuntary commitment, state budgetary constraints and low third-party reimbursement rates for inpatient care.
  • Inpatient care, whether in a state-operated or private hospital, is extremely expensive and such hospitalizations, even though sometimes necessary,  are highly disruptive of the lives of persons with mental illnesses and their families.   
  • The Summit is committed to a mental health system in which there are sufficient community mental health alternatives to prevent unnecessary hospitalizations and to provide alternatives to hospitalizations.  Unfortunately such a system does not exist in Illinois.
  • Thus, there are currently not enough inpatient beds to satisfy the need.  Persons with serious mental illnesses often wait days in Emergency Departments or in non-psychiatric units of general hospitals while waiting for an available bed.

Recommendations:

  • Insure that Illinois provides a full array of recovery-oriented, community mental health services
  • Provide a Medicaid rate structure which will encourage the creation of more community mental health services and encourage more psychiatrists and other mental health professionals to serve Medicaid patients
  • Provide a Medicaid rate structure that permits the maintenance of inpatient psychiatric care in private hospitals.
  • Take advantage of Medicaid waiver programs to expand the type of services provides to persons with serious mental illnesses.
  • Insure that whenever state hospitals are closed, the savings are reinvested in community mental health services.
  • Insure  that when the land underneath state hospitals is sold, the proceeds are invested in mental health services.
  • Insure that persons with serious mental illnesses have access to a full array of psychotropic medications needed to prevent hospitalizations.

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