Psychiatric bed registries have promise when it comes to increasing access to treatment for people with serious mental illness, however much more needs to be done to make them more efficient and useful, according to new research.
Due to the limited supply of psychiatric beds throughout the United States, locating available inpatient beds for individuals in need of psychiatric treatment is challenging. Throughout the country, bed registries have been established to improve efficiencies in the inpatient admission process, reducing strain on emergency departments and providing information to family members on what hospital may have availability for their loved one. In theory, a bed tracking system on an accessible online portal can provide real-time information on where in a given state there is a bed available. In practice, little is known about the effectiveness of these registries in improving treatment access and what limitations there are to their use.
Study results
Researchers from RTI International conducted a systematic review of published academic and grey literature on already published research on psychiatric bed registries. In addition, they conducted interviews with key stakeholders in five states.
The researchers found 17 states with bed tracking systems, however, only five of those states made the bed information available to the general public. No state currently has a bed registry capable of updating automatically; all require the input of bed availability information from the hospital directly.
States financed bed registries through federal grant dollars from the Substance Abuse and Mental Health Services Administration as well as through Medicaid managed care organizations. States have utilized a variety of different strategies to ensure timely updates of bed availability into the system, including through legislation (Virginia), part of the managed care contract (Massachusetts), or by using financial incentives to hospitals (Connecticut).
The majority of interviewees reported that the bed tracking systems had improved clinicians' abilities to find available inpatient psychiatric beds. However, many barriers to implementation of the registries were raised. According to the authors' findings, challenges included persuading hospitals to participate in the tracking system, providers not having the knowledge about how to appropriately utilize the system, and the registry not having enough information about beds meeting particular patient needs.
Bed registries have an important function in providing evidence to the gaps in the psychiatric treatment system. For example, in Massachusetts, government leaders leveraged the information on bed registries to determine a need for more psychiatric beds and convinced hospitals to open five more psychiatric inpatient units, according to the authors. Regardless, more work is needed to improve bed tracking systems to improve access to treatment for people with serious mental illness and make them useful to their family members and clinicians.
