Jared was in his early 20s, autistic, and intellectually challenged with an IQ of 54—a full-grown man with the mind of a troubled child. One day, for no apparent reason, he attacked his mother, and police were called. Jared’s mother watched as her mentally ill son was thrown into a squad car and transported to jail.
A young, sick man went without the mental health care he needed—instead of a hospital bed, he went to a jail cell.
Many of our mentally ill are going without the care they need because of certificate of need laws.
In many places throughout the United States, stories like Jared’s are common. “People who need mental health treatment in many parts of the country can’t get it because of state laws called certificates of need,” Goldwater Institute National Investigative Journalist Mark Flatten says. Under certificate of need laws, government needs to grant permission to open any new treatment facility.
The rationale for these laws is that they’re supposed to control medical costs by limiting the supply of services and facilities to only what is needed. But what they do in reality is protect existing providers from competition—to the detriment of patients who are clearly in need.
Certificate of need laws increase cost, lower quality, and restrict access to mental health care.
Certificate of need laws block would-be healthcare providers from building new treatment facilities, even when there’s a demonstrated need. Take Iowa, one of the many states with certificate of need laws on the books: In Iowa, there is a shortage of mental health facilities that can take care of a person in crisis—a person like Jared. Police officers are forced to crisscross the state to transport such patients to mental health facilities to get the treatment they need. But the time and financial commitment for such trips can be too great for small sheriff’s departments to bear. That means that often, the safest place for someone having a psychotic episode is in a jail cell.
That’s exactly what happened in Jared’s case. He spent days in the county jail, because not a single bed in a mental health facility in the state of Iowa could be located. Yet when a private company sought to build a new mental health facility in Iowa, it was blocked for more than two years by existing providers using certificate of need laws.
Iowa’s certificate of need law made Jared’s situation possible. Jared couldn’t receive mental health care on a timely basis because the supply of hospital bed just wasn’t there. And that scarcity drives up costs and lowers the quality of treatment.
This isn’t hypothetical—it’s real life. A real situation with real people. We are criminalizing our mentally ill. It’s time to change that.
Want to learn more? Read our “What is Certificate of Need?” page here.