RESEARCH WEEKLY: How many psychiatric beds does America need?

(Apr. 19, 2016) With patients in psychiatric crisis waiting days and even weeks in emergency rooms before being admitted to hospitals, it has never been more urgent to quantify how many mental health beds America needs in order to provide people experiencing acute psychiatric symptoms with the same level of intensive care that people in cardiac or other medical emergencies receive.

In a new Treatment Advocacy Center backgrounder, E. Fuller Torrey, MD, founder of the Treatment Advocacy Center, reviews previous bed surveys and new bed supply projections and finds concurrence around a target of 40 to 60 public psychiatric beds per 100,000 population as the “minimum standard currently needed for reasonable psychiatric care in the US.” More effective outpatient services in a community would relieve some need for psychiatric hospital beds, according to “How Many Psychiatric Beds Does America Need?” but “the ultimate safety net of the state psychiatric hospital” will continue to be required for some severely ill patients.

“It is important that we recognize that fact and establish a minimum standard for how many psychiatric beds are needed,” according to the paper, originally published in Psychiatric Times. Specifically, “what percentage of the 40 to 60 beds per 100,000 population should be in state psychiatric hospitals”? No standard exists at this time.

‘No Room at the Inn’
The Treatment Advocacy Center’s 2012 bed survey, “No Room at the Inn,” reported that 14.1 state hospital beds per 100,000 people remained by the end 2010, essentially the same level that existed in 1850. A Duke University team used a computer simulation program in 2015 to model how many psychiatric beds would be needed in one region of North Carolina to reduce emergency room waits to less than one day. The answer was 39 beds, exclusive of those beds for children and inmates with mental illness who have been court-ordered into hospital care.

“The gap between the supply and demand for psychiatric beds grows larger by the day,” said John Snook, executive director of the Treatment Advocacy Center. “Until Congress and the states address the gap by reforming the IMD Exclusion and taking other actions to increase inpatient treatment access, severe psychiatric disease will continue to extract an exorbitant and unnecessary toll from the people who suffer from these conditions and their communities.”

Read the backgrounder now.

References:
Torrey, E. (25 February 2016). A dearth of psychiatric beds. Psychiatric Times.
La, E. M., et al. (1 December 2015). Increasing access to state psychiatric hospital beds:supply-side solutions. Psychiatric Services.
Torrey, E., et al. (2012). No room at the inn: Trends and consequences of closing public psychiatric hospitals. Treatment Advocacy Center.