California needs more acute care beds for residents in crisis. How voters can help | Opinion
It was mid-morning at a busy acute care general hospital in Inland Southern California. A young man had earlier attempted suicide by drinking antifreeze and overdosing on methamphetamines.
Taken to the hospital by EMT personnel, he was stabilized and held in the emergency department. Eventually, he was “warehoused” in a hospital bed with a 24/7 “sitter,” awaiting transfer to a licensed psychiatric hospital facility someplace, anywhere.
There he waited and waited for days because there were no acute care psychiatric beds available in the county, anywhere. Then, one day, when his sitter’s attention was momentarily diverted, the young man slipped out of the hospital bed, exited the upper floor fire escape and jumped to his death.
He was on the edge. All he needed was the care and treatment that an inpatient psychiatric facility could provide and our system failed him. Sound familiar? Perhaps you knew the young man and his family? I certainly did. He was my friend’s son. A tragic story with a horrific ending that unfortunately occurs every day in every county in this state.
Opinion
How can this happen in California? The fifth largest economy in the world. The most compassionate state in the nation. It’s simple: A lack of funding for the full spectrum of behavioral health care, particularly at the acute level, and a lack of commitment to the needs of those in acute psychiatric distress for decades. Despite the fact that the Federal Centers for Disease Control and Prevention tell us that one in five Americans experiences a mental illness and one in 25 Americans has a serious mental illness like schizophrenia, psychosis, bipolar disorder or depression, we allow many of these people to go untreated.
Why? In the ’60s, California moved away from the involuntary hospitalization of those suffering from serious mental illness, except in extreme cases treated long-term in state hospitals. The move away from psychiatric hospitalization, coupled with reduced state funding and a federal limitation on mental health care reimbursements, resulted in a dramatic reduction in the number of available acute care inpatient psychiatric beds in this state, even for those voluntarily seeking treatment.
While some with mental health issues respond with treatment in outpatient settings, others require much more. As a result,over time general hospital emergency departments and local jails rapidly became, and continue to be, the state’s acute care psychiatric treatment facilities. We know the consequences: Overcrowded emergency departments with stretchers lining the hallways housing mental health patients for days — and, in some cases, weeks — and county jails struggling to provide the mental health care they are ill-equipped to provide.
According to a 2021 study by the Rand Corporation, California needs 4,700 more psychiatric beds in counties throughout the state, including a critical need for 1,971 acute care inpatient psychiatric beds for emergency situations where a short-term stay is essential for mental health stabilization and treatment.
Over half of the counties in the state have no acute care beds and most have no beds for children and teens. Riverside County, for example, only has 77 public acute care inpatient psychiatric beds in a county of 2.5 million people — 12 of those are for teens and none for children. Those beds are filled to capacity, with patients holding in emergency departments around the county waiting to get in.
We have a chance to fix this. This year, I was proud to serve as a principal co-author of the Behavioral Health Infrastructure Bond Act of 2023 (Assembly Bill 531) which, if approved by the voters on the March 2024 ballot, will provide, among other things, $1.5 billion dollars to expand the continuum of behavioral health treatment resources, specifically including, for the first time, new acute care inpatient psychiatric beds.
The choice is yours. In the memory of my friend’s son, please vote yes.
Richard D. Roth is a State Senator (D-Riverside) and a member of the Senate Health Committee.
