Pennsylvania reconsiders psychiatric bed registry

(The Center Square) – After years of struggling to connect patients with psychiatric care across the state, the General Assembly wants to create a mental health treatment database to fix the ongoing miscommunication.

The legislation would align Pennsylvania with care coordination offered in other states and is a step in line with recent increases in funding for mental health care.

The proposal, Senate Bill 178, would create a database overseen by the Department of Health “to give providers information on the availability of these beds at participating hospitals with the goal of improving patient care and easing overcrowding in emergency departments.”

The effort has been discussed for years, but has never become law.

“Under federal law, a hospital is required to find a bed for an emergency room patient with a severe and immediate medical need,” Sen. Camera Bartolotta, R-Washington, wrote in a legislative memo. “However, if a hospital is unable to treat an individual with an acute psychiatric problem, emergency room personnel must contact other hospitals to find a vacancy.”

Communication failures have caused open beds to stay empty, with patients in need disconnected from them – driving up costs and hurting the quality of care available.

The registry, if created, would have contact information and details about psychiatric facilities statewide; track the number of available beds along with patient types who qualify; the level of security; and specific facilities appropriate for patients who need temporary detention.

Federal pilot programs have made similar registries common. The Substance Abuse and Mental Health Services Administration (SAMHSA) has funded registries in 23 states to reduce wait times for care; each state received $150,000 as part of a SAMHSA grant. All of Pennsylvania’s border states established a registry as of 2019.

SAMHSA describes a bed registry as part of a “continuum of crisis care” that includes call centers, crisis response teams and community treatment programs.

Registries “have shown clear evidence of success through the years, as well as sustainable, positive impact on state behavioral health systems,” Anita Everett, director of the Center for Mental Health Services of SAMHSA, argued in a 2021 report on bed registries.

“People having a mental health crisis should not be languishing in hospital emergency rooms for days or weeks, or end up being sent home without resolving the crisis because an available treatment setting couldn’t be found,” Everett wrote. “Rather than having care providers call around trying to find available services, an internet-based, bed registry, updated in real time, would allow for prompt, appropriate placement in a variety of settings.”

Efforts to create a registry come in tandem with boosts for mental health and health care funding in general. In November, the Behavioral Health Commission recommended how a $100 million spending boost on mental health should be divvied up, and in December, the commonwealth received $100 million for health care spending from the federal government, with more expected over the next five years