Eye On Boise

State hospitals: 'Ground zero' in care of the mentally ill

Psychiatric hospitalization, which includes community hospitalization for individuals committed to state custody but not yet placed in state hospitals along with State Hospital South and State Hospital North, is recommended for a 2.5 percent funding increase next year by Gov. Butch Otter, to $30.9 million, including $19.3 million in state general funds; the majority of that is for operating State Hospital South, which has 110 psychiatric beds in three units plus a 26-bed nursing facility. State Hospital North has 50 beds. “State hospitals are ground zero, that’s ground zero when it comes to the care of the mentally ill,” H&W official Ross Edmunds told JFAC this morning. “These are the sickest in our state, very challenging.” If they weren’t in the hospitals, he said, “It’s likely many of them wouldn’t be alive.”

More Idaho residents are being committed to the state's psychiatric hospitals, but the length of time they spend in the hospitals is dropping, Edmunds reported. In the current year, the state Department of Health & Welfare expects 818 commitments to state hospitals; the comparable figure in fiscal year 2008 was 473. Mental health admissions to community hospitals also has been on the rise; it rose from 1,019 in fiscal year 2010 to 1,230 in fiscal year 2012. Click below for a full report from AP reporter Rebecca Boone.

Edmunds didn't elaborate on what is behind the icnrease in mental health hospitalizations, but it came as the state's budget for community mental health treatment has suffered major cuts in recent years.

State hospitals provide both short- and long-term, 24-hour residential care for people who can’t remain safely in the community. After funding was provided last year to correct critical staff and patient safety concerns, Health & Welfare is projecting a 39 percent reduction in staff injury from results this year compared to last year, and a 33 percent reduction in the use of restraints and seclusion on patients. Both state hospitals still are reporting difficulty recruiting psychiatrists.

Mental health hospitalizations rising in Idaho
By REBECCA BOONE, Associated Press

BOISE, Idaho (AP) — Officials with the Idaho Department of Health and Welfare say more Idaho residents are being committed to the state's psychiatric hospitals, but the length of time they spend in the hospitals is dropping.

Ross Edmonds with the department's Division of Mental Health told members of the Legislature's budget-setting committee on Wednesday that there were 473 commitments to State Hospital South in Pocatello and State Hospital North in Orofino in fiscal year 2008, compared to a projected 818 commitments for fiscal year 2013.

Mental health admissions to community hospitals has also climbed in recent years, Edmonds said, from just over 1,000 tallied in fiscal year 2010 to 1,230 in fiscal year 2012.

But at the same time, the department has gotten quicker at moving residents from the more expensive community hospitals to the state hospitals once a court orders a longer-term commitment period.

That's important, he said, because the state's cost at community hospitals averages about $760 per patient, per day, compared to around $440 at the state hospitals.

Edmonds didn't elaborate on what is behind the increase in mental health hospitalizations, but the department's mental health budget — like most state budgets — has faced substantial cuts in recent years.

In 2011, Idaho Department of Health and Welfare officials told lawmakers that mental health services had taken a 19 percent budget cut since 2008, forcing the agency to prioritize by first funding intervention services for people in imminent danger to themselves and others, pushing to the bottom of the heap services for those who don't have insurance. At the time, mental health advocates warned that the state would soon reap the results of those cuts in the form of increased demand for crisis mental health services, like emergency hospital commitments.

Lawmakers have been willing to fund some increases, however: Edmonds thanked the members of the Joint Finance-Appropriations Committee for approving nearly $550,000 to add 10 full-time positions at State Hospital South. Those staffers were badly needed, Edmonds said, because the previous staffing level was too low and that was hindering the safety of employees and patients.

The new positions resulted in a 39 percent drop in the number of staffers who were injured by patients last fiscal year, he said, and a 33 percent drop in the use of restraints and seclusion for patients.

Increasing the workforce remains a priority for the department, Edmonds said. State Hospital South needs at least two more psychiatrists and State Hospital North needs at least one, but the department is having trouble recruiting doctors for the jobs.

The average length of stay in Idaho's state mental hospitals is down from more than 80 days in fiscal year 2009 to fewer than 60 days in fiscal year 2012.


Copyright 2013 The Associated Press.




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Betsy Z. Russell
Betsy Russell covers Idaho news from the state capitol in Boise and writes the Eye on Boise blog.

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