Study shows increase in psychiatric hospital stays

Average psychiatric inpatient hospital admissions rose more than 8% in 2011, according to an annual survey by the National Association of Psychiatric Health Systems, which said the need for inpatient behavioral health services continues to grow.

Released Monday, the survey collected 2011 data from 262 facilities, of which 84.5% were psychiatric hospitals and the remaining 15.5% were general hospitals with behavioral health services units. The findings showed that average inpatient hospital admissions increased about 8.8% to 3,053 admissions in 2011 from 2,805 admissions in 2010, while total days of inpatient hospital care rose 18.6% to 30,269 days from 25,529 days. The average number of outpatient visits also went up, rising by nearly 9% in 2011.

Mark Covall, president and CEO of the NAPHS, said the increased demand for inpatient hospital services stems from different factors, starting with the closure of state mental hospitals, which has led to more patients needing to receive mental healthcare services elsewhere. He also said that anecdotally, he's seen a “paradigm shift” in the view of mental healthcare services since the mental health parity law was passed, which happened in October 2008.

“I think people see that mental healthcare is treatable, so we're seeing an increase in need for services,” Covall told Modern Healthcare.

Meanwhile, the survey reported a lower demand for residential psychiatric treatment, which is provided at both residential treatment facilities and hospital-based programs. According to the study, that is reflected in a decrease in total days of care, which is driven by a decrease in the average length of stay. Total average facility residential days of care decreased 2.8% between 2010 and 2011, while the average length of stay in residential programs fell by 7.3% in that same period.

“While the average number of admissions increased substantially from 2010 to 2011, there was a decrease in the average length of stay by patients (-7.3%), leading to a small decrease in total days of care,” the survey noted.

Covall attributed much of the change in residential treatment services to cost. NAPHS members primarily provide psychiatric services in residential treatment programs for children and adolescents. That is largely funded largely by Medicaid, which was squeezed by strained state budgets during the recession. “This is one area of many in the Medicaid program that saw reductions. It was really a tough time for Medicaid programs,” Covall said, adding that another reason for the decrease in total days of residential treatment is that because they're often long programs, states are looking for how that care can be provided elsewhere.

Compiled by Vienna, Va.-based Dobson DaVanzo & Associates, the survey cited statistics from the Substance Abuse and Mental Health Services Administration that one in five adults—or about 45.6 million Americans 18 and older—experienced mental illness in the past year, while 11.5 million experienced a serious mental illness.

Follow Jessica Zigmond on Twitter: @MHjzigmond

(This item has been updated to clarify the increase in admissions.)