Steven S. Sharfstein is President and Chief Executive Officer of Sheppard Pratt Health System in Baltimore, Maryland, and Vice Chair, Department of Psychiatry, University of Maryland, USA.
Correspondence: Correspondence Professor Steven S. Sharfstein, MD, Sheppard Pratt Health System, 6501 N. Charles Street, Baltimore, MD 21204, USA., Email: ssharfstein{at}sheppardpratt.org
Abstract
The number of in-patient beds for psychiatric treatment in America has declined dramatically over the past 40 years. Public and private policies have encouraged an extremely short-term, crisis-stabilisation model of treatment. This is true on both general and subspecialty units. As a result, readmissions have increased, emergency rooms are crowded, and many patients end up homeless or incarcerated in the criminal justice system. These changes have created a public health crisis in America, and are the greatest challenges that American psychiatry faces today.