From NPR 11/30/17
"Many times individuals who really do require intensive psychiatric care find themselves homeless or more and more in prison," Sisti says. "Much of our mental health care now for individuals with serious mental illness has been shifted to correctional facilities."
The percentage of people with serious mental illness in prisons rose from .7 percent in 1880 to 21 percent in 2005, according to the Center for Prisoner Health and Human Rights.
Many of the private mental health hospitals still in operation do not accept insurance and can cost upwards of $30,000 per month, Sisti says. For many low-income patients, Medicaid is the only path to mental health care, but a provision in the law prevents the federal government from paying for long-term care in an institution.
As a result, many people who experience a serious mental health crisis end up in the emergency room. According to data from the National Hospital Ambulatory Medical Care Survey, between 2001 and 2011, 6 percent of all emergency department patients had a psychiatric condition. Nearly 11 percent of those patients require transfer to another facility, but there are often no beds available.
"We are the wrong site for these patients," Dr. Thomas Chun, an associate professor of emergency medicine and pediatrics at Brown University, told NPR last year. "Our crazy, chaotic environment is not a good place for them."
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