How Many Beds? An Overview of Resource Planning

Elpers, John R.; Crowell, Areta

doi:10.1176/ps.33.9.755

Cited by 12 publications

(5 citation statements)

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“…In addition, the implementation of community care complements, but does not replace inpatient care. Even where decentralized services have been developed, it still appears that there are too few inpatient beds to adequately treat acutelyill patients (9,14,34,35,38,42,50,52,53,59,67,72,73,87,106,108,111,118,123).…”

Section: Insufficient and Ineffective Community Servicesmentioning

confidence: 99%

Expert Arguments for Trends of Psychiatric Bed Numbers: A Systematic Review of Qualitative Data

et al. 2021

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Introduction: Mental health policies have encouraged removals of psychiatric beds in many countries. It is under debate whether to continue those trends. We conducted a systematic review of expert arguments for trends of psychiatric bed numbers.Methods: We searched seven electronic databases and screened 15,479 papers to identify expert opinions, arguments and recommendations for trends of psychiatric bed numbers, published until December 2020. Data were synthesized using thematic analysis and classified into arguments to maintain or increase numbers and to reduce numbers.Results: One hundred six publications from 25 countries were included. The most common themes arguing for reductions of psychiatric bed numbers were inadequate use of inpatient care, better integration of care and better use of community care. Arguments to maintain or increase bed numbers included high demand of psychiatric beds, high occupancy rates, increasing admission rates, criminalization of mentally ill, lack of community care and inadequately short length of stay. Cost effectiveness and quality of care were used as arguments for increase or decrease.Conclusions: The expert arguments presented here may guide and focus future debate on the required psychiatric bed numbers. The recommendations may help policymakers to define targets for psychiatric bed numbers. Arguments need careful local evaluation, especially when supporting opposite directions of trends in different contexts.

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Section: Insufficient and Ineffective Community Servicesmentioning

confidence: 99%

Expert Arguments for Trends of Psychiatric Bed Numbers: A Systematic Review of Qualitative Data

et al. 2021

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“…Community-based outpatient services were established to compensate reductions of capacities to hospitalize. However, those services are most effective where strong inpatient care systems are in place (Elpers & Crowell, 1982; Tyrer, 2011). Despite the lack of internationally accepted standards and recommendations (Tyrer, Sharfstein, O'Reilly, Allison, & Bastiampillai, 2017), mental health service experts estimate a minimum rate of 50 psychiatric beds per 100 000 population to be necessary under the assumption that potent outpatient services are available (Torrey, Entsminger, Geller, Stanley, & Jaffe, 2008).…”

Section: Introductionmentioning

confidence: 99%

Psychiatric beds and prison populations in 17 Latin American countries between 1991 and 2017: rates, trends and an inverse relationship between the two indicators

et al. 2020

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Background In 1990, Latin American countries committed to psychiatric reforms including psychiatric bed removals. Aim of the study was to quantify changes in psychiatric bed numbers and prison population rates after the initiation of psychiatric reforms in Latin America. Methods We searched primary sources to collect numbers of psychiatric beds and prison population rates across Latin America between the years 1991 and 2017. Changes of psychiatric bed numbers were compared against trends of incarceration rates and tested for associations using fixed-effects regression of panel data. Economic variables were used as covariates. Reliable data were obtained from 17 Latin American countries: Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, Ecuador, Honduras, Guatemala, Mexico, Nicaragua, Panama, Paraguay, Peru, El Salvador, Uruguay and Venezuela. Results The number of psychiatric beds decreased in 15 out of 17 Latin American countries (median −35%) since 1991. Our findings indicate the total removal of 69 415 psychiatric beds. The prison population increased in all countries (median +181%). Panel data regression analyses showed a significant inverse relationship −2.70 (95% CI −4.28 to −1.11; p = 0.002) indicating that prison populations increased more when and where more psychiatric beds were removed. This relationship held up when introducing per capita income and income inequality as covariates −2.37 (95% CI −3.95 to −0.8; p = 0.006). Conclusions Important numbers of psychiatric beds have been removed in Latin America. Removals of psychiatric beds were related to increasing incarceration rates. Minimum numbers of psychiatric beds need to be defined and addressed in national policies.

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“…The issues of the 1970s continued to be prominent: the role of the state hospital (21,96-101), including whether more state hospitals should be closed (102) or if in fact any were necessary (103); efforts to reduce state hospital admissions (104)(105)(106)(107)(108)(109); and further refinements of state hospital organization and management (110). Perhaps the one new debate-or at least it was formulated more explicitlywas the controversy on the pros and cons of "deinstitutionalization" (111)(112)(113)(114).…”

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confidence: 99%

The Last Half-Century of Psychiatric Services as Reflected in Psychiatric Services

Geller¹

2000

135

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The last half-century of psychiatric services in the United States is examined through developments and trends reported in the 50 years of publication of Psychiatric Services. The journal, earlier named Mental Hospitals and then Hospital and Community Psychiatry, was launched by the American Psychiatric Association in January 1950 and marks its 50th anniversary this year. The author organizes his review of psychiatric services largely around the locus of care and treatment because the location of treatment--institution versus community--has been the battleground for the ideology of care and for the crystallization of policy and legal reform. He uses "dehospitalization" to describe the movement of patients out of state hospitals, rejecting the widely used term "deinstitutionalization" as inappropriate; one reason is that the term wrongly implies that many settings where patients ended up were not institutional. Also covered in detail, as reflected in the journal, are community care and treatment, economics, patient empowerment, and the interface issues of general hospitals, outpatient commitment, and psychosocial rehabilitation. The author notes that some concepts, such as outpatient commitment and patient empowerment, emerged earlier than now assumed, and that others, like psychosocial rehabilitation, recurred in slightly different forms over time. He concludes that even after 50 years of moving patients out of state hospitals and putting them somewhere else, mental health policymakers and practitioners remain too myopically focused on the locus of care and treatment instead of on the humaneness, effectiveness, and quality of care.

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How Many Beds? An Overview of Resource Planning

Cited by 12 publications

References 1 publication

Expert Arguments for Trends of Psychiatric Bed Numbers: A Systematic Review of Qualitative Data

Expert Arguments for Trends of Psychiatric Bed Numbers: A Systematic Review of Qualitative Data

Psychiatric beds and prison populations in 17 Latin American countries between 1991 and 2017: rates, trends and an inverse relationship between the two indicators

The Last Half-Century of Psychiatric Services as Reflected in Psychiatric Services

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