Inside the Rural Psychiatric Hospital Staff Call a '21st Century Asylum'

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1. Privatization doesn't help but there is a severe shortage of mental health workers & infrastructure

Having retired from a hospital administrative position, I can say that even in the wealthiest communities and states, the number of capable and well trained mental health workers is woefully inadequate. And while there is a robust and reasonably well organized system for routine and hospital medical care, there is almost nothing equivalent on the mental health side. If a hospital is impacted by a major influx of patients beyond it's capacity to respond, there is a network that helps by either bringing in more resources, or helping distribute cases to other facilities. We saw this in the pandemic, albeit with the system still highly taxed. But on the mental health side, while docs and social workers try to get mental health patients the type and quality of care they need, there is frequently a lack of beds, staff and alternate facilities to take them. It is not unusual for a patient to present at the ER, get his/her medical issue treated successfully, but then getting stuck there due to an underlying mental health issue, sometimes for weeks and even months. This is most acute for lower income and even many people that have insurance. Given mental health needs in the population that seem to be growing exponentially, fueled by broken families, illicit drugs and income inequality, the situation is only going to get worse.