Institutions for Mental Disease


Institutions for mental disease (IMD) are facilities that have 16 or more beds where individuals reside to treat mental illness, as well as, receive medical and nursing care services (Title 42, Code of Federal Regulations (CFR), § 435.1010). In California, IMDs can be psychiatric hospitals, psychiatric health facilities (PHF), skilled nursing facilities with special treatment programs (SNF-STP), mental health rehabilitation centers (MHRC), or state hospitals.

Statute and Regulations

These are highly restrictive facilities that do not typically provide appropriate services for individuals with intellectual or developmental disabilities (I/DD) and co-occurring psychiatric disabilities. For this reason, current law places severe restrictions and time limitations on the use of IMD residential services by regional centers for individuals with I/DD (Welfare & Institutions Code § 4648(a)(9)(C)).

Additionally, Assembly Bill (AB) 1472 (Chapter 25, Statutes of 2012) – 2012-13 budget trailer bill legislation limits admissions of individuals with I/DD to IMDs and authorizes the use of secured perimeters with delayed egress in licensed homes to enable individuals who would otherwise be at risk of institutionalization to remain in the community.


Last modified: May 8, 2020