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Construction regulations: new approach required.

W W Rice, H J Gershon

The Psychiatric Hospital

|February 4, 1985

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The number of psychiatric beds is increasing, primarily in general hospitals. Current regulations, even in progressive states, often fail to meet the unique needs of psychiatric patients.

Area of Science:

Health Services Research
Psychiatric Care Policy
Hospital Administration

Background:

The number of psychiatric beds has steadily increased since the introduction of Medicare and Medicaid.
Growth in psychiatric beds is more pronounced in medical/surgical settings, through new units or conversions, rather than freestanding psychiatric facilities.

Purpose of the Study:

To analyze the regulatory landscape for psychiatric facilities, particularly in medical/surgical environments.
To evaluate whether existing regulations adequately address the distinct needs of psychiatric patients.

Main Methods:

Review of state regulations governing psychiatric facilities, comparing those adapted from federal guidelines with independently developed ones.
Analysis of regulatory approaches in states with separate regulations versus those using adapted medical/surgical hospital standards.

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Main Results:

Most states adapt regulations from the Department of Health Education and Welfare (now Health and Human Services), originally intended for medical/surgical hospitals.
This adaptation often leads to the neglect of critical differences between patient populations and overlooks specific patient needs.
Even in states with separate regulations, the unique requirements of psychiatric patients may not be sufficiently addressed.

Conclusions:

Current regulatory frameworks, even those attempting to be progressive, are often inadequate for psychiatric care.
There is a critical need for specialized regulations that acknowledge and address the unique needs of psychiatric patients in all healthcare settings.