To the Editor:

Re "Patients Held Against Will by Hospitals" (front page, Sept. 2):

Thank you for your hard-hitting exposé of Acadia Healthcare, a chain of psychiatric hospitals, which revealed Acadia's corrupt financial practices. The authors report on the toxic effects -- including but not limited to driving people away from treatment -- of these unscrupulous procedures.

But even when hospitals have pure motives, inpatient psychiatric care -- especially when it is involuntary -- can be traumatizing, and may lead to an increased risk of suicide: In one meta-analysis, "the postdischarge suicide rate was approximately 100 times the global suicide rate during the first 3 months after discharge."

The key to helping people is funding community-based, evidence-based programs. For example, "Peer-run respites provide a voluntary alternative to an emergency department visit or inpatient hospitalization for people experiencing a psychiatric crisis," as was noted in a recent article in Psychiatry Online.

With so much evidence to support the benefits of community-based mental health care, I believe that a paradigm shift in the mental health system -- away from hospitalization and toward community-based treatment, including peer support -- is long overdue.

Susan Rogers

Cherry Hill, N.J.

The writer is the director of the National Mental Health Consumers' Self-Help Clearinghouse.

To the Editor:

The motivation for this atrocious behavior is cited in the first paragraph of the article, where it is noted that Acadia Healthcare's stock price has more than doubled. This is an example of the perverse results of the use of private equity to finance health care. There are other such examples.