APA: New digital model created to address psychiatric bed crisis in the U.S.

The American Psychiatric Association has issued a report detailing a strategy for addressing the crisis of psychiatric bed availability and need.

The report includes the creation of a digital model that aims to help communities estimate needs and link resources.

“It is no secret that we have a dire need for psychiatric inpatient beds in this country,” Saul Levin, MD, MPA, CEO and medical director of the APA, said during a virtual press briefing on the report. “But so far, we have not been able to make the most of our available resources because we’ve not had a good way to assess the needs and identify the areas where they might do the most good.”

Saul Levin

The report — courtesy of the American Psychiatric Association Presidential Task Force on Assessment of Psychiatric Bed Needs in the United States — assessed the multifaceted issue with the goal of informing decisions of community leaders and policymakers alike in future development of service capacity. It was organized into seven sections — historical context, definitions, financing, population factors and special populations, community factors, children and adolescents, and the development of the model concept.

Anita Everett, MD, APA past president and current director of the Center for Mental Health Services, touted simplicity of usage for the computer-based simulation model, which was created from information within the report, describing it “not unlike a simulation game where you change the information and get different results.”

However, she noted, development of the model is dependent upon contact from communities directly to the APA regarding a desire for involvement.

Sandra DeJong, MD, chair of the Task Force Subgroup on Child and Adolescent Psychiatric Beds, said during the briefing that the report revealed the need for child psychiatric beds increased while the actual number decreased due to a number of factors such as a shortage of child psychiatrists throughout the “vast majority of the country” as well as evidence that showed admittance for the youngest populations is easiest in summer, but more difficult in both spring and fall.

“We thought of at least 10 ways the inpatient needs of youths differ from adults,” DeJong added. “The first is that children and adolescents are a vulnerable and independent population that we are legally mandated to ensure the safety of.”

DeJong further offered that children are hospitalized for issues such as mental illness arising from physical health issues, developmental problems, such as a combination of autism and anxiety disorder, psychosocial reasons like trauma arising from witnessing chronic domestic violence.

Reasons for the psychiatric bed shortage ranged from implementation of the managed care system, financial pressures on the current health care system, increase of demand, increasing diagnoses, greater research, staffing issues, insurance type, location and distance of emergency services from a given community, and the onset of the COVID-19 pandemic.

Levin additionally stated the big question is how to encourage parents to speak on the inequities in the health care delivery system to their local representatives, adding that success of the model requires the interest and participation of more people to in-turn add increased input into the system.

Everett suggested that once the community-based model is firmed up, the next trial will take place at the state level before the possibility of national usage.

Reference:

• APA. The psychiatric bed crisis in the U.S. https://www.psychiatry.org/psychiatrists/research/psychiatric-bed-crisis-report. Published Aug. 15, 2022. Accessed Aug. 16, 2022.