When the decision has been made to move forward with psychiatric admission, a patient's care team may also need to determine which hospital to send a patient to. This is an important question to consider because while psychiatric needs are medical needs, psychiatric care may not be the only medical need a person has.
Sometimes, a hospital will have a psychiatric unit, just like it may have medical units, surgical units, or an intensive care unit. In general, it is more common to find a dedicated psychiatric unit embedded in larger urban hospitals that are designed to provide many types of care. Dedicated units are also more frequently found in academic medical centers. Due to the variety of specialties available in one facility, these psychiatric units may have more flexibility in terms of which patients they can admit. For example, sometimes embedded psychiatric units can admit patients who may also need to be frequently seen by multiple medical specialties. They may also be able to admit psychiatric patients who also need certain regular procedures like IV medications, multiple imaging studies, or dialysis. Depending on the person's overall healthcare needs, the psychiatry team may be the primary or the consulting team.
However, most acute care hospitals do not have their own dedicated psychiatric units. In California, only 79 of the 440 general acute care hospitals have a dedicated psychiatric unit.
So where are the other psychiatric beds?
In general, they are in freestanding psychiatric hospitals. These are hospitals designed for psychiatric care only. The equipment, staffing, and sometimes even of the physical design of these hospitals is focused on psychiatric treatment. As a result, freestanding psychiatric hospitals are not designed to care for patients who have a variety of acute medical needs. In general, the psychiatric treatment team will only make minor adjustments to already existing treatment plans from other specialties. However, in general, free standing psychiatric hospitals have more psychiatric beds available and might be able to admit a patient sooner.
Finding an appropriate psychiatric inpatient bed for a patient is a complex process. The interactions between patient presentation, health insurance, facility ability, and bed availability often lead to several discussions amongst the care team on what might be the best possible option for a patient.
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