Advances in Psychiatric Treatment (2009) 15: 402-403. doi: 10.1192/apt.bp.109.006957
© 2009 The Royal College of Psychiatrists
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Letter from America: acute in-patient psychiatry bed shortages

Steven S. Sharfstein

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.