Assessing the Optimal Number of Psychiatric Beds for a Region

  • Robert E. DrakeEmail author
  • Michael A. Wallach

O’Reilly et al.’s paper in this issue on determining optimal numbers of psychiatric beds makes a number of important arguments and offers an interesting approach, but errs by relying on anecdotal, inconsistent, invalid data, which often lead to incorrect conclusions (Gueron 2007). In this commentary, we lay out points of agreement, disagreement, and omission, and suggest additions to their proposed research.


Several of the authors’ starting points deserve emphasis. Many countries have been reducing psychiatric hospital bed capacity for decades, many regions are struggling to meet mental health needs, and some patients with complex needs undoubtedly require more supervised treatment for a time. Nevertheless, the optimal number of beds per capita for any system of care remains unknown. Countries define bed types, psychiatric disorders, and lengths of stay in different ways, making comparisons across countries difficult if not impossible. Computerized algorithms—systems for...


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Conflict of interest

The authors report no conflicts of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.The Dartmouth Institute for Health Policy and Clinical PracticeDartmouth CollegeHanoverUSA
  2. 2.IPS Employment Center, Rivermill Commercial CenterWestatLebanonUSA
  3. 3.Professor Emeritus of Psychological and Brain Sciences, Department of Psychology and NeuroscienceDuke UniversityDurhamUSA

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