The shortage of forensic psychiatric beds in Maryland state hospitals described in the Sept. 29 article, "Judge holds Maryland officials in contempt, orders them to open dozens of psychiatric beds," is the latest result of inadequate funding and a fragmented service delivery system. National Alliance on Mental Illness (NAMI) Maryland believes that every person with a mental illness should have access to a full continuum of timely and effective treatment, including hospitalization, in both the civil and criminal justice systems.
The current crisis has been building for a long time, over several administrations. For years, the state has significantly reduced the number of state hospital beds, with no corresponding increase in funds to effectively treat and provide services in the community, especially for forensically engaged individuals. When diversion is not appropriate, there is still a need to address the behavioral health issues that may have led to the criminal behavior.
The ability of the court to commit a defendant to treatment is a very important mechanism; however the period in which a defendant is assessed and if necessary placed in a treatment facility must be immediate. Delays in treatment tend to increase the severity of a mental illness and consequently the intensity and cost of the services being provided. Further, as forensic hospital admissions have increased, the state is faced with denying non-forensic patients hospital admissions or boarding patients in emergency rooms until a hospital bed is available.
At NAMI Maryland, we are acutely aware that these issues are complex and that long term solutions are necessary to divert individuals with mental illness to treatment and services — before arrest, after arrest and at all points in the justice system. However, the state can and must take steps to address this crisis now, by increasing the number of hospital beds, along with staffing increases. The costs are to high when individuals are unable to access timely and effective treatment — high rates of incarceration in jails and prisons, costly treatment in emergency rooms, high rates of unemployment and lost productivity. Apart from the clear financial cost to our systems, there are also human costs: loss of hope, damage to families and relationships, and suicide.
The writer is Policy and Advocacy Director for National Alliance on Mental Illness Maryland.
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