Construction regulations: new approach required

The growth in the number of psychiatric beds has continued unabated since the passage of Medicare and Medicaid, and trends indicate further development will occur. While freestanding facilities have grown in number, a greater degree of growth in beds has occurred in the medical/surgical environment where psychiatric patient units have been developed or have been converted from other purposes. In regulating these different types of psychiatric facilities, most states have adapted regulations from those developed by the Department of Health Education and Welfare (now Health and Human Services) that apply to medical/surgical hospitals. The result is often a situation where important distinctions between patient populations are ignored or patient needs are overlooked. Some more progressive states have developed regulations that are independent of HHS' requirements. The authors have found that even in those states where separate regulations exist, the unique needs of psychiatric patients may not be met.