You might have seen the front page article in the Denver Post on Sunday about the inpatient services for mental health crises in the metro area.  The article outlines concerns that the mental health profession has about the shrinking availability of inpatient psychiatric beds, which involves intensive care in a secure facility individuals may need during a mental health or emotional crisis, such as a suicide attempt.  The news is deplorable.  Indeed, Ms. Auge, the author, noted that in December the American College of Emergency Room Physicians ranked Colorado the 50th of 50 states in the number of inpatient beds.  For example, our state has approximately 11.8 current psychiatric beds for every 100,000 people, a decrease from 17 in 2005, and widely disparate from the nationwide average which is about 30.  The metro area currently has about 380 psychiatric beds for adults in seven facilities, a drop of nearly 66% since 1990.  This is because about eight hospitals have closed units in the last decade, and the latest casualty was University of Colorado Hospital's psychiatric unit, a place that served primarily indigent and un-insured individuals. 

And this drop is not because of lack of demand, or inability to fill those beds either.  According to the Post article, about 40,000 mentally ill show up in Colorado emergency rooms each year and about 40% of those need hospitalization and intense crisis services.  Many psychiatric units are generally 80-90% full in the metro area.  The real reason is money.  Many psychiatric facilities run their programs in the red, not only due to difficulties with reimbursement from managed care companies, but also because a large portion of those who are admitted do not have insurance or do not have adequate mental health benefits on their plan.  Fortunately, the mental health parity legislation will be taking effect in October this year, which will require medical plans that include mental health services to cover services equal to medical coverage.

But regardless of why units are closing, our ranking for mental health services is not acceptable.  While psychologists and mental health professionals generally agree that the least restrictive services should be offered when possible, there will always be times when an individual is not stable enough to make that decision for themselves, and involuntary or crisis services will be needed in order to keep them safe.  Especially with state budget surpluses in recent years, more money needs to be funneled to provide these kind of services when necessary.