CALL TO ACTION
US deaths from COVID-19 have climbed to more than 12,000 and the whole country is focused on ending this pandemic. The same determined attention needs to address another “pandemic” that is growing and ignored — serious mental illness (SMI). When the COVID-19 pandemic is contained (this might require many months), newly constructed field hospitals and other “extra” COVID-19 beds should be retained to serve the seriously mentally ill. These resources must not be co-opted or lost. Which individuals/organizations have the influence and political will — right now — to take this on, plan, and make it happen? Suggestions?
BACKGROUND
1) According to the National Institutes of Mental Health (2019), nearly one in five US adults lives with a mental illness (46.6 million people in 2017).
2) The Centers for Disease Control and Prevention (CDC) reports that more than 50% of the population will be diagnosed with a mental illness at some point in their lifetime. One in 25 Americans lives with a serious mental illness, such as schizophrenia, bipolar disorder, or major depression.
3) A 2016 paper by Treatment Advocacy Center finds that serious mental illness has become so prevalent in the US corrections system that jails and prisons are now commonly called “the new asylums.” Los Angeles County Jail, Chicago’s Cook County Jail, or New York’s Riker’s Island Jail each hold more mentally ill inmates than any remaining psychiatric hospital in the United States. Overall, approximately 20% of inmates in jails and 15% of inmates in state prisons are estimated to have a serious mental illness. Based on the total inmate population, this means approximately 383,000 individuals with severe psychiatric disease were behind bars in the United States in 2014 or nearly 10 times the number of patients remaining in the nation’s state hospitals.
4) Mental Illness Policy Org estimates that close fo half of all Americans with mental illness aren’t getting treatment.
5) As stated by Constellation Behavioral Health, the cost of untreated mental illness is high. Patients hospitalized with serious mental illness are much more likely to be readmitted in the next 30 days if they do not receive follow-up treatment. The average hospital cost for a patient readmitted for a mood disorder is $7,100. Mental illness and substance abuse often co-occur, increasing the risk of death from overdose. There were 70,237 drug overdose deaths in the US in 2017. As many as 90 percent of cases of suicide are attributed to mental illness.
6) Wikipedia notes that the US has one of the highest suicide rates among wealthy nations. In 2018, there were 48,344 recorded suicides, up from 42,773 in 2014, according to the CDC's National Center for Health Statistics. On average, adjusted for age, the annual US suicide rate increased 24% between 1999 and 2014, from 10.5 to 13.0 suicides per 100,000 people, the highest rate recorded in 28 years. Due to the stigma surrounding suicide, it is suspected that suicide generally is underreported.
7) According to the Psychiatric Times (2016), the shortage of psychiatric beds in the US is a major problem. Nevertheless, many states continue to decrease the number of state hospital beds. Given findings by various experts, it seems reasonable to establish a range of 40 to 60 psychiatric beds per 100,000 population as a minimum standard.
CALL TO ACTION
US deaths from COVID-19 have climbed to more than 12,000 and the whole country is focused on ending this pandemic. The same determined attention needs to address another “pandemic” that is growing and ignored — serious mental illness (SMI). When the COVID-19 pandemic is contained (this might require many months), newly constructed field hospitals and other “extra” COVID-19 beds should be retained to serve the seriously mentally ill. These resources must not be co-opted or lost. Which individuals/organizations have the influence and political will — right now — to take this on, plan, and make it happen? Suggestions?
Photo credit: Valerie Everett/Flickr