Over the last several decades, individuals with serious mental illness have increasingly been transitioned out of hospitals and into community-based settings. This shift from state to community-based service delivery has resulted in the shuttering of state hospitals across the country without sufficient increase in the availability of specialty, community-based psychiatric beds. As the number of inpatient psychiatric beds has decreased, health care providers have increasingly struggled to secure inpatient services for individuals who are in psychiatric crisis. Providers must frequently contact multiple facilities with no guarantee that an appropriate bed may be available. The lack of psychiatric beds has escalated the pressure on hospital emergency departments, which are called to serve individuals on voluntary and involuntary psychiatric holds while awaiting transfers to psychiatric facilities.
The State of Michigan and Michigan Legislature have pursued several strategies over the last few years to expand access to inpatient psychiatric beds and improve the quality of care for individuals who have experienced a psychiatric crisis. These strategies include: (1) expanding the number of psychiatric beds that are available through the Certificate of Need program, (2) approving funds to pursue the building of a new facility to replace the existing Caro Center, (3) establishing a new unit at the Center for Forensic Psychiatry, (4) collecting and examining data on the causes of denials for inpatient services, and (5) facilitating transitions of care through the Children’s Transition Support Team pilot. Despite these various efforts, the crisis in access to inpatient psychiatric services has continued unabated.
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