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Michigan psychiatric centers cut number of beds despite having more money – Bridge Michigan

“It is mentally and physically exhausting. And when you have a big caseload, it can be dangerous. Do you give the wrong medication out because you’re overwhelmed? Do you forget to lock a door, because you’re overwhelmed?”

Fischer said he can’t blame the state.

“We can’t afford to lose psychiatric beds, but there really are safety issues,” he said, adding, “it would not be difficult for some patients to overpower staff if there aren’t enough staff.” 

Michigan has a mix of private and public mental-health facilities that offer outpatient and hospitalized care. State-run hospitals typically supply about a quarter of the in-patient psychiatric beds available in Michigan, but have an outsized role in taking on the most challenging cases. 

There are five state-run psychiatric centers in Michigan, including four for adults. The daily volume of residents fluctuates according to the needs of the patients and availability of staff: 

  • The Kalamazoo Psychiatric Hospital served an average of 103 patients a day in August, the most recent numbers available from MDHHS. That’s down from 151 people in April. Over that time, 50 beds were taken off-line at the hospital.
  • The Walter Reuther Psychiatric Hospital in Westland, west of Detroit, served 148 people a day in August, down from 167 patients in April. Twenty of its beds were taken off-line.
  • The Caro Center east of Saginaw, along with the Saline-based Center for Forensic Psychiatry, which provides evaluation and treatment for criminal defendants, did not have any beds closures.  

The Hawthorn Center in Northville, which handles children, cared for about 39 patients a day in August, compared to 50 in April. The state has closed seven beds at Hawthorn. But officials said the closures were temporary and prompted by construction, not a lack of staff. When the work is completed next year, Hawthorn is expected to greatly expand its bed capacity to accommodate 78 to 80 children in crisis. 

More money but a tough sell  

The bed closures in Kalamazoo and Westland are another hit to Michigan’s thread-bare, state-run behavioral health system. Wait times for placements in psychiatric hospitals for patients with complex, sometimes violent, mental illnesses can stretch from days to weeks or more. 

In a threepart series last year, Bridge Michigan chronicled the despair of families whose children were “boarded” in hospital emergency rooms while they waited for one of the state’s too-few psychiatric beds. 

The cuts come as the state is investing more in psychiatric hospital care. The budget to operate the state’s five in-patient hospitals for people with severe mental illness or intellectual or developmental disabilities grew to $347 million this coming year, a $44 million increase from four years ago, according to the state’s budget office.

But state health officials voice some of the same frustrations as private businesses in their failed efforts to fill openings.  

According to online job postings at indeed.com, the Reuther hospital seeks help in food service, where jobs start at $14 and $15 an hour. An opening on the state’s website for a “domestic service aide” in Kalamazoo starts at $19, while an activity therapy aide post starts at $21 an hour. Elsewhere, there are job postings for resident care aids (starting at $19 an hour) as well as for higher-paid clinical social workers, nurses and a psychiatrist.

Mellos said there has been a small uptick in applications for entry-level positions, but the state faced a “hiring desert” for much of the summer.

Direct-care staffers with a high school diploma “can make more money driving Lyft and Uber and DoorDash,” while having greater flexibility on when they want to work, Mellos said. 

Trickle-down problems 

State hospitals play a unique and crucial role in the larger mental health field, traditionally providing treatment for patients with the most chronic, complex psychiatric problems that can necessitate months-long stays followed by intensive follow-up in local Community Mental Health agencies.

A reduction in state beds increases demand for beds at privately owned hospitals and facilities, which generally offer shorter stays, with patients returning home after their crisis has stabilized.

Yet privately owned hospitals and clinics also face shortages in staff and available beds. 

Michigan currently has 2,301 privately-operated adult psychiatric beds in its inventory, which the state said is more than 170 beds short of what’s needed.

Since October 2020, workforce shortages across Michigan hospitals have closed 1,400 acute-care inpatient beds throughout the state, according to a report the Michigan Health & Hospital Association sent the legislature Thursday. 

That includes hospital beds in psychiatric units, though a precise number was not immediately available, said MHA spokesperson John Karasinski.

“We are working with the state to try and figure out how to make it through this crisis,” Laura Appel, MHA’s executive vice president of government relations and public policy, said of the bed shortage. “At the same time, I can’t blame (state officials) for their challenges.”