Certificate-of-need laws are causing a mental health crisis among Arkansas teens

The red tape causing a shortage of mental health treatment for Arkansas kids

Jul 20, 2022 by Kevin Schmidt

Arkansas is facing an adolescent mental health crisis, and the government is causing it.

Due to several factors, including the ongoing pandemic, demand for adolescent mental health treatment is skyrocketing.

But a little-known Arkansas law banning the development of new facilities or additional beds is forcing parents to take children to emergency rooms ill-equipped to provide psychiatric care.

One executive of an Arkansas children’s hospital warned,

“[I]npatient facilities are full and they’re strapped for space and staff, and the length of time it takes to transfer a child to the appropriate inpatient setting is 50 to 75 percent longer now than it was 18 months ago.”

“Right now for our teens, we have a state of mental health emergency,” Dr. Buster Lackey of the National Alliance on Mental Illness Arkansas told THV11.

The pandemic strained even the strongest health care systems, but Arkansas ranks among the worst states for youth mental health:

48^th in the nation according to the United Health Foundation’s 2021 annual health rankings
47^th in the nation according to Mental Health America’s 2021 rankings

This is because the Arkansas’ youth mental health care system is stuck in 2008.

Since that year, Arkansas law has prohibited adding beds or constructing new psychiatric residential treatment facilities (PRTFs), 24-hour psychiatric facilities for children and adolescents between six and twenty-one years of age.

Predictably, the moratorium creates an artificial shortage of facilities.

The state’s own PRTF bed need calculation, last updated on June 30, 2022, identifies an aggregate shortage of 53 beds across the state, including shortages of 62, 62, and 21 in three of the six designated geographical areas:

While other states have realized their error, Arkansas stands alone with this moratorium that is hurting juvenile health care outcomes.

According to the National Conference of State Legislatures, only 13 other states utilize moratoriums on health care services, and no other state maintains a moratorium on residential treatment facilities for adolescents.

Mississippi repealed its moratorium on child/adolescent psychiatric or chemical dependency beds in March 2021.
Tennessee no longer requires a Certificate of Need (“CON”) for psychiatric services after passing CON reform in 2021.
Washington state extended its CON exemption for psychiatric facilities to 2023 in order to “alleviate the need to board psychiatric patients in emergency departments.”
Florida eliminated CON requirements for numerous services including, “intensive residential treatment facilities services for children.”

Freezing the supply of beds and facilities since 2008 provides a government-granted monopoly to the current facilities — that can count on a steady stream of patients regardless of quality of care — reduces options for patients, and strains an already overburdened hospital system.

Download Americans for Prosperity Foundation-Arkansas’s report detailing how certificate-of-need laws are keeping our kids from getting the mental health treatment they need.