РУАЭСТ (RUAEST)
EMERGENCY ROAD TRIPS: AN ANALYSIS OF SPATIAL BARRIERS TO INPATIENT STATE PSYCHIATRIC CARE FOR SELECT U.S. STATES
From its peak in the 1950s, the number of state psychiatric inpatient beds in the United States has decreased steadily. Today, not one U.S. state meets the generally accepted minimum of 50 inpatient beds per 100,000 in the population. Mississippi comes closest at 39.0 beds per 100,000. The last time the inpatient psychiatric bed situation was so dire was 1850 [1], when the plight of the seriously mentally ill first attracted attention in the U.S. Deinstitutionalization is the result of societal shifts and policy changes over the last half century, and while the effect in the U.S. has been particularly stark, the broader trend is on display in many high income European countries [2]. By the 1970s, psychiatric hospitals had gained a reputation for substandard care, the likes of which was the subject of the 1975 Jack Nicholson film One Flew Over the Cuckoo’s Nest, which was filmed at Oregon State Hospital in Salem, Oregon. That hospital opened in the mid-1880s and is still in operation despite numerous citations for unsafe conditions and asbestos exposure [3].