Pennsylvania hospitals struggle under demand for mental health beds

Oct. 12--More than 300 Pennsylvanians a day were hospitalized for mental illness in 2018, leaving mental health professionals in many instances struggling to find beds for them in a system plagued by limited resources.

The numbers, detailed in a new report by the Pennsylvania Health Care Cost Containment Council, found the hospitalization rate statewide for mental illness averaged 88.8 per 10,000 residents, with rates spiking in areas struggling with above-average poverty and lower levels of education.

The Centers for Disease Control and Prevention says up to half of all Americans will be diagnosed with a mental illness or disorder at some point during their lives.

Indeed, CDC records show, mental illnesses, such as depression, are the third most common cause for hospitalization in the U.S. among those aged 18-44.

The new Pennsylvania report found depression accounted for 44% of mental health hospital admissions, with schizophrenia and bipolar illness accounting for 20.7% and 20.2% of admissions. Hospital stays for those admitted for mental illnesses averaged 10.7 days.

Dr. Keith Stowell, president of the Pennsylvania Psychiatric Society, is a psychiatrist at UPMC Western Psychiatric Hospital in Pittsburgh. He said hospitalization rates statewide reflect shortages across the spectrum of mental health care.

According to Stowell, patients brought to hospitals suffering from mental illness often spend hours or days in hospital emergency rooms, waiting for an available psychiatric bed. Children and those with intellectual disabilities are often the hardest to place because of the limited number of beds available to meet their needs.

"We do have a shortage of psychiatric beds, but if we had better outpatient services to meet patients' psycho-social needs, we would not have as much of a crisis," Stowell said.

Dr. P.V. Nickell, chairman of the psychiatry department for Allegheny Health Network, said the shortage of inpatient psychiatric beds has been exacerbated by a shortage of trained psychiatric nurses.

"In our hospitals we have licensed beds that we can't always fill because of a lack of nurses," he said. "Finding psychiatric inpatient nurses is getting harder because the illnesses we see are more severe and inpatient psych nurses get burned out pretty quickly."

Nickell said a lack of care or an inability to access care for mental illness can lead to other problems.

"AHN provides medical and psychiatric care to the Allegheny County Jail," he said. "And I have said without tongue in cheek that it is the biggest psychiatric hospital in the area."

Experts say such issues reinforce the need for community-based mental health services.

Rachel Jackson, manager of behavioral health services at Excela Health, said such services are a critical component of Excela's efforts to meet mental health needs in Westmoreland County, where hospitalization rates of 94.2 per 10,000 residents are slightly above the state average.

"Our focus of hospitalization is to address their immediate needs, provide stabilization, and formulate a thorough and actionable discharge plan that focuses on their natural supports and strengths," Jackson said.

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Deb Erdley is a Tribune-Review staff writer. You can contact Deb at 724-850-1209, [email protected] or via Twitter .

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