State Psychiatric Hospitals Grapple with Increased Criminal Justice Referrals and Capacity Issues
State psychiatric hospitals across the United States are facing operational challenges, primarily due to a substantial increase in patients admitted through the criminal justice system. This shift has led to extended patient stays and reduced availability of beds for individuals seeking mental health treatment. Investigations have documented these issues through interviews with patients, families, current and former hospital staff, advocates, legal professionals, and behavioral health experts.
Shifting Patient Demographics and Capacity Decline
Nationwide, psychiatric hospitals are experiencing staffing shortages, resulting in patients being turned away or encountering long waits for treatment. A growing proportion of individuals admitted to these facilities are court-ordered following criminal charges.
In Ohio, the percentage of state hospital patients with criminal cases rose from approximately 50% in 2002 to about 90% today. This increase in criminally involved patients has coincided with a 50% decrease in the total number of patients served by Ohio's state psychiatric hospitals over the past decade, from 6,809 to 3,421. Nationally, the total number of patients served decreased by approximately 17% during the same period.
The decline in state facility capacity occurs concurrently with the closure of psychiatric units in local hospitals, which often serve patients with Medicaid or those who are uninsured. The financial stability of local hospital mental health services is expected to deteriorate further after Congress passed legislation that would reduce federal Medicaid funding over the next decade.
Retired Ohio Supreme Court Justice Evelyn Lundberg Stratton characterized the constrained flow of new patients as a