Penn Medicine Bioethicists Call for Return to Asylums for Long-Term Psychiatric Care

JAMA Viewpoint Characterizes Current Model for Treating Mentally Ill as “Ethically Unacceptable and Financially Costly”

As the United States population has doubled since 1955, the number of inpatient psychiatric beds in the United States has been cut by nearly 95 percent to just 45,000, a wholly inadequate equation when considering that there are currently 10 million U.S. residents with serious mental illness. A new viewpoint in JAMA,written by Dominic Sisti, PhD, Andrea Segal, MS, and Ezekiel Emanuel, MD, PhD, of the department of Medical Ethics and Health Policy in the Perelman School of Medicine at the University of Pennsylvania, looks at the evolution away from inpatient psychiatric beds, evaluates the current system for housing and treating the mentally ill, and then suggests a modern approach to institutionalized mental health care as a solution.

“For the past 60 years or more, social, political and economic forces coalesced to move severely mentally ill patients out of psychiatric hospitals,” write the authors. They say the civil rights movement propelled deinstitutionalization, reports of hospital abuse offended public consciousness, and new drugs gave patients independence. In addition, economics and federal policies accelerated the transformation because outpatient therapy and drug treatment were less expensive than inpatient care, and the federal legislation like the Community Mental Health Centers Act and Medicaid led to states closing or limiting the size of so-called institutions for mental diseases.

However, the authors write, “deinstitutionalization has really been transinstitutionalization.” Some patients with chronic psychiatric diseases were moved to nursing homes or hospitals. Others became homeless, utilizing hospital emergency departments for both care and housing. But “most disturbingly, U.S. jails and prisons have become the nation’s largest mental health care facilities. Half of all inmates have a mental illness or substance abuse disorder; 15 percent of state inmates are diagnosed with a psychotic disorder.” According to the authors, “this results in a vicious cycle whereby mentally ill patients move between crisis hospitalization, homelessness and incarceration.”

The Latest on: Long-Term Psychiatric Care

[google_news title=”” keyword=”Long-Term Psychiatric Care” num_posts=”10″ blurb_length=”0″ show_thumb=”left”]

via Google News

Ethical challenges of genome editing

The Latest on: Long-Term Psychiatric Care

The Often Vicious Cycle Through SF’s Strained Mental Health Care and Detention System
on May 6, 2024 at 6:23 am
In San Francisco, people in mental distress who are involuntarily detained on “5150 holds” can cycle repeatedly through the care system.
Washtenaw United: Care-Based Safety serves as an safer alternative to solving mental health crises
on May 6, 2024 at 4:40 am
There is growing support for an alternative to police response to a mental health crisis in the community. The question is: Can it be a safer and more effective tool in dealing with such incidents for ...
Long-term sickness: How worsening mental health is holding back the economy
on May 4, 2024 at 12:00 am
Economic inactivity, driven by long-term sickness, is fast becoming one of the most pressing challenges facing the UK economy.
Drug court offers hope — and solutions — for long-term recovery and improved public safety
on May 3, 2024 at 11:00 am
Julie Christenson-Collins is director of Substance Use Disorder Services and Integrated Care at the Greater for the Nashua Mental Health Center. Jacalyn Colburn is the presiding justice for the ...
Arizona ranks 49th in nation for access to adult mental health care
on May 1, 2024 at 10:22 am
PHOENIX – Mental Health America ranked Arizona 49th ... “The end result of not providing these long-term and acute levels of care is that families are feeling that heavy burden.” ...
Arizona ranks 49th in nation for access to adult mental health care
on April 30, 2024 at 2:47 pm
Mental Health America ranked Arizona 49th on its national list for adult mental health care, indicating a higher prevalence of mental illness and lower access to care within the state.
The Evolution of Mental Health Care
on April 30, 2024 at 8:31 am
The contemporary approach to mental health care revolves around a continuum-of-care model, offering multiple levels of support tailored to individual needs. This model includes various options, from ...
Navy Says New Data Indicates No Long-Term Health Effects from Red Hill Spill as Trial Gets Underway
on April 29, 2024 at 2:02 pm
The Navy released several documents on medical appointment history before and after a 2022 spill at the Red Hill Bulk Fuel facility dumped jet fuel into the base housing water supply.
Kamloops man fighting to get mom with dementia into long-term care
on April 29, 2024 at 6:59 am
There are few individuals I’m angry at, the system is what I’m pissed off with, the way these assessments are required, leaving people hanging around taking up beds. I wouldn’t treat my dog like we ...
Full-spectrum mental health care changes lives
on April 26, 2024 at 5:38 am
One in five adults nationwide experience mental illness, and nearly one-third of those people do not receive the treatment needed.