State hospitals closed but new treatment options lag behind, report finds

Byberry, Malboro, Allentown, Hagedorn — there’s a long list of closed state-run psychiatric hospitals in the region. The goal in closing mental hospitals was to get people out of institutions, and to provide treatment more effectively and humanely in their communities.

But a new report from the Treatment Advocacy Center claims the closings have left many mentally ill people without treatment options, and that people in crisis end up in emergency rooms, jails and on the streets.

The report titled “No Room at the Inn” finds that states have been closing hospitals more quickly in the past five years as they looked for ways to save money.

Thirteen states closed 25 percent or more of their total state hospital beds from 2005 to 2010, the report states. Ten states increased their total hospital beds but continued to provide less than half the beds considered to be minimally adequate to meet public need.

Psychiatrist E. Fuller Torrey with the Treatment Advocacy Center says states have failed to provide alternatives. “We have done a very good job of emptying out the hospitals in all of the states,” Torrey says. “We have done a very poor job of providing care in the community for people who need treatment, and who don’t get follow-up treatment.”

Fuller says the lack of treatment options for people in crisis is expensive. People with mental illness are crowding emergency rooms or languishing in jails.

Mental health advocates say the closing of hospitals was ultimately a positive thing, as it ended often needless institutionalization of people, but they agree that treatment options within communities are lacking.

Mark Salzer, who chairs the Department of Rehabilitation Sciences at Temple University, says that the long-term investment in community mental health services didn’t come to fruition in most communities around the country.

“So deinstitutionalization was happening, and absolutely policymakers and legislator saw a cost-saving opportunity here, where they didn’t fully invest all funds back into the community mental health services,” Salzer says.

Salzer says that Philadelphia County has done better than many other municipalities in terms of creating options for community treatment after closing state hospitals.