A monthly public policy newsletter from the
Mental Health Association in Michigan (MHAM)
Future of New State Psychiatric Hospital in Caro Uncertain
The future of a new replacement hospital in Caro (for the one that has existed there) is now up in the air.
Governor Snyder and the Legislature had taken some early steps toward a replacement state operated hospital that would remain in Caro. But the Whitmer administration has put this on hold while it seeks consultative assistance on the matter.
In a mid-March statement, MDHHS Director Robert Gordon said there will be a delay “as a result of concerns about staffing shortages, ability for patients’ families to be involved in their treatment and water accessibility.” He went on to say, “This delay will allow an outside consultant to review the project and determine next steps.” The “old” Caro Center will continue to serve inpatients, and a consultant’s recommendations are expected by July.
Officials from the Caro community are upset, and that is understandable, as they don’t want local jobs to be lost (542 FTEs in Governor Whitmer’s proposed FY-20 budget).
We have no idea on the water situation in Caro. When it comes to family involvement, since we only have three state psychiatric hospitals for adults and just one for children, all of them represent potential visitation and involvement difficulties depending on where one lives. And as for staff shortages, would those be as problematic as at Caro if a new hospital wound up in mid-Michigan or the northern Lower Peninsula?
What we do know for sure is that studying the Caro situation can’t be used as an excuse for taking the current Caro beds (average population of 145 for FY-19) offline and not replacing them somewhere.
Michigan has far too few state-operated psych beds. The state’s FY-19 budget calls for 530, excluding the Forensic Center (budgeted for 240). And the 530 beds are filled with forensic (criminal involvement) cases because the Forensic Center doesn’t have enough beds to meet demand. (Governor Whitmer’s FY-20 budget proposal includes a $2m increase for speedier Forensic Center evaluations.)
The Treatment Advocacy Center (Virginia) has said we’re one of the five worst per capita states in the country for state-operated psychiatric beds. About 35 years ago, many thought licensed psychiatric beds in communities could effectively replace state operated hospitals. That has proven to be a pipedream, as the average length of stay in community beds is around six days – not nearly enough time to adequately stabilize someone – because of insurance and other economic factors.
Additionally, Michigan has significantly fewer community beds than it did 20-25 years ago, and the private and community hospitals housing those beds don’t want to admit persons with the potential for disruption and combativeness.
Many elements of Michigan’s behavioral health community came together 20 years ago and said Michigan needed at least another 400 state-operated beds (split evenly between adults and children). Of course, we have less state-operated beds today than was the case two decades ago.
We wish no one ever had to be in a psychiatric hospital bed. But given the current science of treatment technologies, some people at some points in their lives will clinically require psychiatric hospitalization. When they do, only state-operated hospitals can provide a length of stay sufficient for effective stabilization of symptoms and functioning. What Michigan has done and left itself with is a shameful disgrace. Only an aroused citizenry can create the political will to fix the situation.
And if the “old” Caro comes offline with no replacement of its beds somewhere else, that would be a further tragedy. We’re not saying that’s what anyone has in mind. But when you look at Michigan’s history on state-operated beds, it would be naïve to conclude Caro’s beds will automatically be replaced. Failure to replace those beds cannot happen!
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