In 2022, a bipartisan group of Georgia lawmakers intends to address the state’s glaring shortage of mental health professionals. If they are to succeed, one of the greatest challenges might be finding — and keeping — staff at the state-run psychiatric hospitals.
A dearth of workers now leaves patients waiting days, weeks or even months to be admitted. On Thursday, more than 300 people were waiting to be treated, officials said, while well over 100 state beds sat empty.
Some patients wait in local hospitals already overwhelmed by COVID-19 cases, or in jails where staff are often not equipped or trained to give them the level of care needed.
The state’s five inpatient mental health facilities — in Decatur, Columbus, Augusta, Savannah and Milledgeville — are operated by The Georgia Department of Behavioral Health and Developmental Disabilities. The state psychiatric hospitals treat people who’ve been committed or found incompetent to stand trial in criminal cases.
The department, which in pre-COVID times had 4,000 workers, has seen a net loss of 1,000 workers since the start of 2020, according to state records. The turnover rate in the 2021 fiscal year was 34 percent agency-wide, 39 percent in the hospitals. The Columbus facility had a turnover rate of nearly 50 percent. The resignations, like others across the health care industry, came as nurses and others eye better pay in less stressful conditions.
Judy Fitzgerald, commissioner of the Department of Behavioral Health and Developmental Disabilities, said the agency is struggling to compete for workers during the pandemic.
“Competition for the healthcare workforce is at a fever pitch, and as other healthcare providers and staffing agencies offer signing bonuses and higher wages, the State’s ability to compete in this market has decreased,” Fitzgerald said in a statement Thursday. “We share the concerns of our partners in law enforcement, the judicial system and emergency departments, who are bearing the brunt of workforce shortages across the behavioral health crisis continuum.”
Department staff are exploring ways to combat the problem, officials said, and are hopeful lawmakers can assist in the upcoming legislative session. A bipartisan bill is in the works to overhaul mental health care in the state, with the shortage of workers high on the list of challenges. It’s expected to be submitted in the next legislative session, beginning Jan. 11.
Of the hospital system’s 1,066 beds, 15 percent of beds routinely sit unused, state records show. Some of those are open because they’re part of COVID-19 quarantine units and waiting for patients who may need temporary isolation, but officials say the most pronounced barrier to admitting new patients is staffing.
Defense attorneys across metro Atlanta and elsewhere in the state are frustrated to see clients forced to wait so long for the level of care they need.
“I never had anybody just sort of languish prior to the pandemic,” Chris Van Rossem, assistant Hall County public defender, said. But delays are now common enough that officials in Hall have regular check-ins with the state for status updates.
One of his colleagues had a case that illustrated the perils of long wait times. A young man came to jail facing misdemeanor family violence charges and was found incompetent to stand trial last summer. Two months later, he had to be rushed to Northwest Georgia Medical Center after refusing food and medicine inside the jail.
“Basically, he was just dying,” said Anna Szatkowski, the man’s attorney, who recently moved to the DeKalb County Public Defender’s Office.
The man has since improved, but not before ending up with a new charge. In jail, he was charged with a felony for damaging government property, allegedly breaking a sprinkler. Szatkowski said it’s a common charge for people struggling with mental illness in jail.
At state psychiatric hospitals, officials say it’s rare for a patient to be charged with such an offense.
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Baldwin County Sheriff Bill Massee, who’s seen longer wait times for prisoners in his jail needing state services, said mentally ill prisoners picking up new charges during long jail stays can be a problem. He said his deputies try not to charge prisoners with new crimes if it appears the alleged crime was caused more by a psychiatric issue than criminal intent. “We do (file charges) when we have to,” he said, “but we don’t want to.”
Massee has been frustrated for years with mental health services in the state. He remembers when the state shuttered the sprawling — and notorious for numerous reports of patient abuse — Central State Hospital in 2010. Since then, there have been more people struggling with mental illness in the jail, said the sheriff, who’s been in office since 1989.
“We are the mental health providers — the jails and the prisons in the state of Georgia,” Massee said.
Massee brags about his jail health care staff. “But quite candidly,” he said, “we’re detention officers and nurses — we’re not mental health professionals. ... We would rather them be in a clinical bed than be in a correctional setting.”
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