Hundreds of Minnesotans with mental health problems are languishing in hospital psychiatric units for weeks, even months, because they have nowhere to go for less intensive care, according to a comprehensive study to be released this week.
As a result, private hospitals are absorbing millions of dollars in unreimbursed costs, while patients who are well enough to be released are being deprived more appropriate care at a fraction of the cost.
The study, by the St. Paul-based Wilder Foundation, is the first statewide analysis of delays in the discharge of psychiatric patients from private hospitals, and it highlights deep and dangerous flaws in Minnesota's system for treating people with mental illnesses. The study is expected to be closely read by key legislators, as it comes just weeks after Gov. Mark Dayton's task force on mental health held its first meeting to develop recommendations for mental health reform.
Researchers found that nearly one in five psychiatric patients in Minnesota are stuck in hospital beds even after they are stabilized and ready for discharge, because of bureaucratic delays and a severe lack of other treatment options. That amounts to nearly 50,000 potentially avoidable hospital days a year, according to the study of 20 hospitals. On any given day, about 130 patients across the state are sitting in psychiatric beds who do not need that level of hospital care — occupying beds that could be used by patients facing dire emergencies, the study found.
The bottlenecks are straining Minnesota's hospitals, causing overcrowding in emergency rooms and leaving fewer beds for new patients. In some cases, mental health patients wait on stretchers in hallways, or are sent as far away as Fargo or Sioux Falls, because local psychiatric beds are already full, say hospital administrators. "This is, by far, the most pressing public health crisis in our state," said Dr. Rahul Koranne, chief medical officer for the Minnesota Hospital Association, which commissioned the study.
Nils Peterson, 47, who is diagnosed with bipolar disorder, said he is still baffled about why he was confined to a psychiatric unit for nearly three weeks earlier this summer.
Peterson, a nurse from Rochester, said he was taken to the Mayo Clinic in June while in the throes of a psychotic breakdown, which he says was largely triggered by a decision weeks earlier to stop taking his medications.
Over the course of a few days, he became increasingly manic and delusional, convinced that he was on the verge of producing a blockbuster Hollywood film. He began calling and e-mailing friends and relatives as far away as California, urging them to send money for his grandiose film project. "I really got swept up in some out-of-this-world thinking," he says. "There was no question I was sick and needed help."
