State lacks psychiatric facility beds
Due to a statewide shortage of physiatric beds, it can take up to 24 hours for a person facing a dangerous mental health incident to get placed in a facility that can meet their needs.
“When we have someone who comes into the hospital for a crisis assessment, if they meet the criteria for what’s called a 5150, which is when you hold someone involuntarily because they’re a danger to themselves or others, it’s then our job to find a placement for them at a psychiatric hospital,” said Phebe Bell, Nevada County behavioral health director.
Each month, the behavioral health crisis team conducts about 180 crisis assessments during mental health incidents, leading to 25 involuntary psychiatric holds. However, the ratio of beds to population — ideally 50 per 100,000 residents — has been declining since the mid-1990s to a low of 17 per 100,000 in 2016, according to a California Hospital Association study.
This has led to wait times throughout the state that could last days, according to the Collaborative Healthcare Patient Safety Organization report.
“In some cases, the long stays become contributing factors for workplace violence and staff safety, an issue mentioned in nearly one out of four (24%) cases reviewed,” it states.
Locally, the lack of bed availability led the county to contract with nearly a dozen psychiatric health care facilities with placeholder terms, since they never know which facilities will have room until calling around as needed.
One example is Restpadd Health Corp., whose contract began last year at $25,000 before growing to more than $400,000 over two years due to being available and seeing more use. According to Bell, the overall cost of the placements is on par with previous years. As one contract is used more, others are used less.
“You never know when you place somebody how long they’re going to be there — it depends on who has room and what patient needs we have,” she said.
While the lack of beds has impacted emergency departments in some counties, according to Bell, Nevada County’s crisis stabilization unit has mitigated that by providing those patients with a stress-free environment to get care outside the emergency room.
“Often times there is substance use co-occuring with the mental health disorder, and once somebody sobers up they’re not suicidal anymore or they’re not so upset anymore so that person might go home with a safety plan,” she said.
To contact Staff Writer John Orona, email email@example.com or call 530-477-4229.
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