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LINCOLN — State officials contend a new report shows that Nebraska succeeded in closing psychiatric beds at two state hospitals without dumping patients on the street.
But some advocates for overhauling the state’s mental health services aren’t convinced.
They say the report raises as many questions as it answers about the fate of people released during the push to replace hospital care with community-based services.
“What actually happened with these people?” asked J. Rock Johnson of Lincoln. “What kind of housing are they in? Do they have services that are working for them?”
The report, released last week by the State Department of Health and Human Services, was done by researchers at the University of Nebraska Medical Center College of Public Health.
It followed up on 1,225 people discharged from general psychiatric care at the state’s three regional centers from 2005 through 2008.
Scot Adams, behavioral health director for HHS, said the report verifies that fears about patients being shoved out without services were not realized.
“We were not discharging simply to the shelter or the street,” he said. “Behavioral health reform, by and large, appears to be working for a significant group of people.”
He pointed to the study’s finding that 76 percent of those discharged got behavioral health and other community-based services, such as medical care or economic assistance.
He also noted that the study found readmission rates for those patients were about half the national average.
The study showed that 12 percent of patients were readmitted to a psychiatric hospital within six months of discharge during the year ending June 30, 2009.
That compares to a 21 percent readmission rate nationally, according to figures collected by the federal government.
“That represents a level of quality of care, both at the regional center and in the community,” Adams said.
Advocate Mary Angus of Omaha said she was glad Nebraska is doing better than the national average. But she said the state could do better.
She pointed to a finding that one in five patients was readmitted to a hospital at some point during the four-year study.
“To me that shows, nationally and in Nebraska, we’re missing community supports that could keep them out,” Angus said.
She noted that the study also showed heavy use of emergency services, another sign that people were not getting sufficient help. Forty-three percent of the discharged patients used emergency shelters or crisis inpatient services at least once during the study period. In addition, 29 percent of patients were placed in emergency protective custody.
Angus said Nebraska needs to be more creative in developing services that can keep people functioning in the community and out of institutions. However, she said, the state has been adding some promising services. For example, peer support networks are being developed in all regions of the state.
Adams said that 316 regional center general psychiatric beds have been closed as a result of the behavioral health overhaul.
The last seven general mental health patients were transferred from the Norfolk Regional Center to the Lincoln Regional Center in June, he said.
That leaves the Norfolk institution serving exclusively sex offenders.
Adult behavioral health services at the Hastings Regional Center were closed in April 2007. That institution now houses a substance abuse treatment program for juveniles and a program for developmentally disabled adults who are considered too dangerous to live in the community.
The Lincoln center now has 90 general psychiatric beds. It also serves sex offenders and psychiatric patients who are involved with the court system.
Closing the psychiatric beds freed up more than $30 million, which was transferred into the community-based service system to increase the number and type of services available.
The study found that most of the discharged patients had serious mental illness in combination with other diagnoses, such as substance abuse, personality disorder or mental retardation.
Those patients were more likely than the general population to have medical problems. The study noted that people with serious mental illness die, on average, 25 years earlier than the rest of the population, and many of the deaths are from preventable illnesses.
Contact the writer:
402-473-9583, martha.stoddard@owh.com
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