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Indiana is facing a crisis we can no longer afford to ignore: Our state does not have enough psychiatric hospital beds to meet the growing demand for behavioral health treatment. This shortage is not just a statistic—it has devastating consequences for our communities, particularly our jails and criminal justice system. Without swift and decisive action, more Hoosiers struggling with mental illness and substance use disorders will not receive the treatment they desperately need and end up behind bars.
The number of state psychiatric hospital beds has dropped to a historic low nationwide, with Indiana no exception. New research from the Treatment Advocacy Center shows that in 2023, the number of state hospital beds was less than 11 per 100,000 people—an astonishing 8% decrease since 2016. This decline has pushed psychiatric hospitals beyond capacity, with a median occupancy rate of 90%, even though the recommended threshold is 85%. When hospitals can no longer take in new patients, it creates a bottleneck that forces individuals in crisis to remain in emergency rooms, jails or on the streets.
This bed shortage is particularly devastating for individuals in the criminal justice system. Nationwide, forensic patients—those entangled in legal proceedings—occupy 52% of total psychiatric hospital beds. When hospitals reach occupancy, the burden falls on local jails, which have become the default holding facilities for people in mental health crises. Research showed, across 26 states, inmates spent a median of two months in jail waiting for a bed to open—a reality that I know Indiana sheriffs witness daily.
The consequences and human cost of this crisis are immeasurable. Imagine your loved one experiencing a severe schizophrenic episode. Family members call the police because they’re desperate and don’t know where else to turn. Instead of receiving immediate medical care, your loved one is booked into jail, where his or her condition can deteriorate. Your loved one struggles to understand what is happening without proper treatment. By the time your loved one finally gets a psychiatric hospital bed, weeks or even months have passed. The psychiatric condition has worsened, the family is traumatized, and the road to recovery is even steeper.
County jails are not designed to provide mental health care, yet sheriffs and correctional officers are forced to step in and keep the lid on the jail as it is a pressure cooker. Sheriffs and correctional officers are not trained psychiatrists or addiction specialists, yet they must manage individuals in crisis. This is not only an unfair burden on law enforcement; it is an ineffective and callous way to address mental illness. Without appropriate care, individuals cycle in and out of jail, their conditions deteriorating, and taxpayers foot the bill for a broken system that is overloaded.
The situation is dire, but it is not irreversible. State leaders must prioritize behavioral health and take immediate steps to increase the number of psychiatric hospital beds in Indiana. This requires targeted investments in infrastructure and staffing. The Treatment Advocacy Center report highlights several key recommendations that Indiana should adopt, including balancing the number of civilian and forensic beds, increasing salaries to recruit and retain mental health professionals and implementing better tracking systems to ensure timely discharges.
We have seen what happens when states fail to invest in mental health care. The pandemic exacerbated staffing shortages, leading to the closure of 15% of psychiatric beds nationwide. Some states have taken more proactive steps, offering tuition subsidies and salary increases to attract employees. Indiana must follow suit. Failing to act will only deepen the crisis.
This is not a partisan issue; it’s a public safety and human rights issue. We need state legislators’ commitment. The Governor’s Office and health officials must expand access to psychiatric care and relieve the burden from our jails. More beds, more trained professionals and more resources will change lives, improving the outcomes for Hoosiers struggling with mental illness and enhancing our community’s safety.
Indiana cannot afford to wait another day. Treatment providers must make it a priority now to expand the number of beds available to patients—and the rest of us must do our part to facilitate their work.•
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Luce has served as executive director for the Indiana Sheriffs Association since 2009.
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