Under pressure to fix its mental health system, Georgia is embarking on an uncharted course: the total privatization of state psychiatric hospitals.
In an escalation of earlier plans for limited privatization, officials now want to hire for-profit companies to build and operate three new psychiatric facilities to replace all seven existing state hospitals, according to documents obtained by The Atlanta Journal-Constitution. The last of the old facilities would close by 2012.
The move would end 150 years of state-provided psychiatric care in Georgia, marked by frequent revelations of horrid conditions, reforms, more revelations and more reforms. Now the state confronts a confluence of challenges: up to 10 percent budget cuts and an investigation of the hospitals by the U.S. Justice Department. [. . .]
Now, however, they are proposing a complete reshaping of the system. Psychiatric units for children and adolescents would close. Adult patients would be housed in one of two new hospitals; one somewhere in metro Atlanta, the other in south central Georgia. And criminal defendants who may be mentally incompetent to stand trial would be brought from across the state to a single forensics facility, in Milledgeville, for evaluation and treatment. [. . .]
The state began examining its psychiatric hospitals last year after the Journal-Constitution reported that abuse, neglect and poor medical care contributed to 136 deaths from 2002 through 2007.
The Justice Department investigation added urgency to state efforts. In May, the department cited an "unabated" failure to address dangerous conditions that have caused preventable deaths, injuries and illnesses. State officials are negotiating an agreement that would forestall a lawsuit charging Georgia with violating patients' civil rights.
Similar investigations in other states have led to massive spending to upgrade or replace hospitals. Georgia ranks near the bottom in per-person spending on mental health care; reaching the average spending level would add at least $480 million to the current budget of more than $700 million.
The expanded privatization plan appears to be intended to make dramatic changes without proportionate increases in spending, according to organizations briefed by Walker.
"Everybody's take is that there's no [new] money," said Terry Norris, executive vice president of the sheriffs' association. "They're trying to maximize what they've got."
The last quote is key—Georgia officials are embracing privatization as a primary strategy for doing more with less. As I alluded to in my Reason.com column last week, I suspect we're going to be hearing an increasing number of similar refrains from state officials across a spectrum of policy areas as they reckon with growing budget shortfalls.
More on state psychiatric hospital privatization here.