Maintaining Availability of Resources at all Levels of Care

As the recognition of mental illness becomes more prevalent, the need for treatment resources at all levels of care becomes increasingly more vital. These resources include, but are not limited to, longterm care facilities, short-term care facilities, acute care units, emergency rooms, outpatient psychiatric treatment programs, substance abuse treatment programs, etc. All levels are care, in most (if not all) areas of the country are facing increasing demand and stagnant (if not dwindling) supply.

For quite some time, it has been acknowledged that long-term care facilities to treat the chronically and severely mentally ill may not be ideal solutions to a very complex problem. For many years, such institutions operated with standards that would be considered unacceptable in practice today. This lead to the coined term “De-institutionalization Movement” which started in the early 1960’s. However, the community resources which promised to fulfill the role of caring for this patient population in less restrictive settings never came to full fruition. Additionally, despite vigorous therapeutic efforts, some patients simply cannot be treated at a lower level of care in the community.

Due to lack of other resources, many patients with serious mental illness become essentially wards of the state in the form of prolonged or repeated incarceration, further creating a drain on resources that are already critically limited. Also, emergency rooms are being over utilized as a last option by patients that cannot access care elsewhere, and such locations can actually worsen mental illness given the characteristics of that environment. Therefore, to reduce this “trickle-down” effect, long-term care facilities continue to be necessary resources for the treatment of a certain segment of this patient population which are unable to be maintained at a lower level of care. Along the same lines, allocation of resources to lower levels of care must also be adequate to provide the most humane, appropriate, and effective treatment modalities for all patients with mental illness. Therefore, it is the position of the NJPA that we must continue to advocate for the fair and just distribution of adequate support for all levels of care, from the most restrictive to the least restrictive, in all communities.

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