(Oct. 25, 2017) Today, we have laws that require mental health parity, equal coverage of care for mental illness in comparison to medical and surgical conditions, yet we still see challenges surrounding those issues. We also understand that individuals with mental illness, especially serious mental illness, can present with periods of relative stability and symptom resolution but also have periods when symptoms manifest more visibly.
For any individual with serious mental illness, care and treatment requires various levels of support at different times. All too often, however, access to such care can be delayed or thwarted.
As waitlists for services have received public attention, all too often the cry for "more beds" becomes a quick response that seems like an easy answer to a complex problem. Beyond Beds: The Vital Role of the Full Continuum of Psychiatric Care is a new report by the National Association of State Mental Health Program Directors (NASMHPD) that is co-released by the Treatment Advocacy Center.
Beyond Beds utilizes a case study, the fictional story of Taylor, a young adult with serious mental illness, to highlight the places where a seamless mental health service system can align to improve outcomes for individuals in need of care. The report further delineates areas of need to enhance the system of care that exists today. Ten key policy recommendations are offered as a framework for that discussion.
Origins of Beyond Beds
The paper was originally developed by NASMHPD, the entity that brings together state mental health executives responsible for the $41 billion public mental health service delivery system serving 7.5 million people annually and funded through the Substance Abuse and Mental Health Services Administration. NASMHPD convened experts to help develop 10 technical papers on the current state of psychiatric inpatient capacity in the United States and other special topics. Beyond Beds represents the umbrella paper of the series, providing overarching ideas to compliment the other nine reports. Realizing the importance of the paper and need for broader dissemination, NASMHPD worked with the Treatment Advocacy Center to release the paper to the public.
Written by a psychiatrist and administrator, Debra A. Pinals, MD, along with an advocate and family member of a person with serious mental illness, Doris Fuller, Beyond Beds aims to help address different aspects of care, such as housing and technological advances, and highlights needs of specific populations within the mental health system.
Both NASMHPD and the Treatment Advocacy Center have consistently supported the vital role of psychiatric hospital beds for individuals with serious mental illness. In Beyond Beds, we build on that important message to detail the different types of beds and other types of services-including acute and crisis services-necessary for a functioning mental health system and describe how such beds fit into a comprehensive system of care that reduces negative consequences of untreated and undertreated serious mental illness.
And the message is clear. Proper care and support of individuals with serious mental illness requires policymakers to look "beyond beds" toward a full continuum of psychiatric care to meet treatment needs over time.
 Elizabeth Sinclair Research Associate |
Debra A. Pinals, MD Medical Director, Behavioral Health and Forensic Programs Michigan Department of Health and Human Services Clinical Professor of Psychiatry Director, Program in Psychiatry, Law and Ethics University of Michigan |