Limited hospital bed space proves challenge in caring for mentally ill

Hospitalizing mentally ill people against their will takes more than a court order. It requires bed space.

In recent years, state government budget cuts have "damaged our mental-health system," particularly in hospital care for acutely ill patients, said psychiatrist Asif Qaisrani, medical director of the Community Counseling Center in Cape Girardeau.

"We lost a lot of beds," he said. "Many patients were left homeless."

The result is that individuals with mental illness often "fall through the cracks and the legal system picks them up."

"There are more patients being treated in the prison system than in mental-health institutions nationwide," he added.

Fifty public and private hospitals in Missouri have psychiatric units, but less than half take involuntary commitments.

That further limits available bed space.

The closest hospitals to Cape Girardeau that accept involuntary commitments are in St. Louis, Farmington and Poplar Bluff, Missouri, according to Community Counseling Center staff. Such facilities have locked units with security cameras.

"A judge won't sign off on an involuntary commitment unless there is bed space," said Victoria Dormeyer, director of outpatient/emergency services at the Community Counseling Center. "That person has to sit in ER with police until my staff can find the bed space. At times, it can take as long as 48 hours before we can provide bed space."

She added, "We can't always ensure there is bed space."

In some cases, the closest available bed is more than four hours away in Nevada, Missouri, on the west side of the state, Dormeyer said.

Community Counseling Center staff try to place patients in mental-health facilities as close to home as possible to make it easier for family members to visit.

Even in cases of voluntary commitments, she said the goal is to keep clients from having to make long trips.

"Most of our clients are low-income," she said, explaining they lack reliable transportation.

Locally, the Community Counseling Center works to develop a discharge plan for treatment of the patient who is ready to be discharged from a psych unit.

Cathy Brock, a crisis-intervention specialist with the Community Counseling Center, said the state of Missouri "has been very consistent in legislation and philosophies to protect clients' rights."

Under Missouri law, individuals who receive mental-health services have the right to humane care and treatment.

According to the Missouri Department of Mental Health website, the mentally ill have a right "to be evaluated, treated or habilitated in the least restrictive environment."

They have the right to participate in the development, review and revision of their individual treatment plans and to have access to their mental and medical records.

mbliss@semissourian.com

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