On Wednesday, concerned community members gathered in upper Manhattan to rally against a proposal by New York-Presbyterian to close 30 inpatient psychiatric beds at Allen Hospital in Inwood. Their concerns are warranted.
New York state has a shortage of at least 4,300 inpatient psychiatric hospital beds that has left some of the most seriously mentally ill without enough access to appropriate treatment options. The responsibility for approving these closures lies with Gov. Cuomo’s commissioner of mental health, Dr. Ann Sullivan; Cuomo should not let her approve them.
Allen Hospital’s 30 beds are among the approximate 2,840 hospital beds for psychiatric patients in New York City where those with serious mental illnesses are able to receive treatment. Experts at the Treatment Advocacy Center recommend having at least 50 beds per 100,000 people, putting New York state (at 16.3 beds per 100,000) very short.
New York state has a shortage of at least 4,300 inpatient psychiatric hospital beds...
Annually, Allen Hospital’s psychiatric ward is used by around 600 patients — patients who would likely otherwise end up cycling between emergency rooms, homelessness and incarceration. Without access to hospitals, the cycle has become a norm for this difficult-to-treat population.
Since 2010, the state has lost more than 1,741 public psychiatric beds. Over this same time span, those with mental illness on Rikers Island have risen from about 30 percent of the population to more than 40 percent, despite a decrease in the overall prisoner population. At least one-third of New York City’s growing homeless population suffers from a serious mental illness; 50 to 70 percent of homeless mentally ill are also suffering from substance-abuse disorders.
Those who are homeless are more likely to come in contact with the criminal justice system and law enforcement. Police, who have become first responders to those with mental illness, receive more than 150,000 calls for emotionally disturbed persons annually.
New York-Presbyterian defended its request to close the beds by arguing that it will expand — eventually — outpatient services throughout the city. But for many of those whom these beds currently serve, outpatient care isn’t enough.
“If you find yourself in a crisis and need round-the-clock care, a hospital would be the only place you would find support,” says Matt Kudish, the executive director of the New York chapter of the National Alliance for Mental Illness.
In Allen Hospital’s place, New York-Presbyterian plans include sending patients to their Westchester Division, Brooklyn Methodist Hospital and Gracie Square Hospital. These locations are distant and will leave the poorest, for which travel is more difficult, without access to appropriate psychiatric services.
Inpatient treatment is a last resort for individuals who can’t be successfully treated in community settings or may be dangerous to themselves or others. Even if community mental-health services were more oriented toward serving patients with serious mental illness, rather than the “worried well,” there will still be some who need more intensive longer-term inpatient care in a hospital setting.
Local, state and federal lawmakers — both Democrats and Republicans — have spoken out against the closure and disagreed that these patients would still be provided adequate “vital health services” at a “convenient, nearby location.” Unfortunately, no such leadership has been seen from Mayor de Blasio, who has yet to weigh in on the situation despite constant touting of his administration’s prioritization of mental health.
In his State of the State Address, Cuomo admitted that there is a mental health problem and committed to fixing it. He should start by listening to the bipartisan group of leaders — and the close to 1,500 Inwood community members — who are up in arms, and reject the proposal to decertify these beds. And he shouldn’t stop there, but also reject future closures to inpatient beds as well.
This piece originally appeared in the New York Post
Carolyn Gorman is the project manager for education policy and mental-illness policy at the Manhattan Institute.