Title: No Room at the Inn: How the Federal Medicaid Program Created Inequities in Psychiatric Hospital Access for the Indigent Mentally Ill
Abstract: Deinstitutionalization, the discharge of thousands of psychiatric patients from state hospitals, has largely been attributed to one or more of the combination of the following: inhumane conditions at psychiatric hospitals; belief that psychiatric illnesses didn't really exist; theories that the mental hospital produced psychiatric illness; belief that institutionalized individuals would function better outside of a hospital; lawsuits requiring that due process rigidly restrict who can be placed involuntarily in hospitals, thus preventing the mentally ill from ever becoming hospitalized; and the development of medications that alleviated the most devastating symptoms of mental illness. This article argues that the federal Medicaid program actually resulted in massive numbers of the mentally ill being not only released from psychiatric hospitals, but ensured that these individuals would ultimately be left to the streets, jails and morgues. While Medicaid provided coverage for indigents receiving medical for all other illnesses, the Medicaid provision known as the Institutions for Mental Disease (IMD) exclusion eliminated funding for all indigent psychiatric patients treated in state-owned psychiatric hospitals. Thus, IMD gave a financial incentive to the states to discharge psychiatric patients and close psychiatric hospitals. The result has been the complete abandonment of the indigent mentally ill.
Publication Year: 2004
Publication Date: 2004-02-12
Language: en
Type: article
Access and Citation
Cited By Count: 2
AI Researcher Chatbot
Get quick answers to your questions about the article from our AI researcher chatbot