Are There Enough Inpatient Psychiatric Beds?

  • Eric Slade
  • Marisa Elena Domino


In this chapter, we examine key issues and controversies surrounding whether the current psychiatric inpatient bed supply is adequate or alternatively whether more psychiatric beds are needed. Fueled by changes in federal and state mental health policy, insurance reimbursement practices, the scientific evidence for the effectiveness of mental health treatments, and care management practices, psychiatric service systems are constantly changing in ways that can affect overall psychiatric bed need within a region. Consequently, to assess whether the current bed supply is adequate in relation to the population need for psychiatric beds, it is essential to both compare local information regarding the capacities of the various types of inpatient psychiatric facility providers and consider the impacts of regional use of community mental health services and supports that may diminish the need for inpatient beds. It is also important to consider the effects of professional shortages, which may increase the overall costs of additional psychiatric inpatient beds. Well-designed inpatient capacity simulation models that take into account the complexity and dynamics of psychiatric inpatient utilization and sources of payment for psychiatric inpatient care may help fill gaps in our current understanding of the need for added bed capacity.


  1. 1.
    Breakey, W. R. (1996). Inpatient services. In W. R. Breakey (Ed.), Integrated mental health services: Modern community psychiatry (pp. 264–275). New York: Oxford University Press.Google Scholar
  2. 2.
    Substance Abuse and Mental Health Services Administration. (2014). Crisis services: Effectiveness, cost-effectiveness, and funding strategies (HHS Publication No. [SMA]-14-4848). Rockville, MD: Substance Abuse and Mental Health Services Administration. Retrieved from
  3. 3.
    Grob, G. N. (1992). Mental health policy in America: Myths and realities. Health Affairs, 11(3), 7–22.CrossRefGoogle Scholar
  4. 4.
    Pow, J. L., Baumeister, A. A., Hawkins, M. F., Cohen, A. S., & Garand, J. C. (2015). Deinstitutionalization of American public hospitals for the mentally ill before and after the introduction of antipsychotic medications. Harvard Review of Psychiatry, 23(3), 176–187. Scholar
  5. 5.
    Grob, G. N. (2006). The dilemma of federal mental health policy: Radical reform or incremental change? New Brunswick, NJ: Rutgers University Press.Google Scholar
  6. 6.
    Geller, J. L. (2006). A history of private psychiatric hospitals in the USA: From start to almost finished. Psychiatric Quarterly, 77(1), 1–41. Scholar
  7. 7.
    Morrissey, J. P., & Goldman, H. H. (2020). Division of labor: Function shifts and realigned responsibilities in the evolving mental health services system. In H. H. Goldman, R. G. Frank & J. P. Morrissey (Eds.), The Palgrave Handbook of American Mental Health Policy (Chap. 2, pp. 21–48). New York: Palgrave Macmillan.Google Scholar
  8. 8.
    Judge David L. Bazelon Center for Mental Health Law. (2017). Mental health systems: Overview. Retrieved from
  9. 9.
    Treatment Advocacy Center. (2017). Psychiatric bed shortages. Retrieved from
  10. 10.
    Fisher, W. H., Geller, J. L., & Pandiani, J. A. (2009). The changing role of the state psychiatric hospital. Health Affairs, 28(3), 676–684. Scholar
  11. 11.
    Welsh, C. (2008, November 25). The debacle of deinstitutionalization: History and politics of community mental health centers [PDF document]. Presentation of University of Iowa Department of Psychiatry Grand Rounds. Retrieved from
  12. 12.
    Frank, R. G., & Glied, S. A. (2006). Better but not well: Mental health policy in the United States since 1950. Baltimore: Johns Hopkins University Press.Google Scholar
  13. 13.
    Lutterman, T., Shaw, R., Fisher, W. H., & Manderscheid, R. W. (2017). Trend in psychiatric inpatient capacity, United States and each state, 1970 to 2014 [Assessment #10]. Alexandria, VA: National Association of State Mental Health Program Directors. Retrieved from
  14. 14.
    U.S. Census Bureau. (2012). Table 2: Population: 1960 to 2009. In U.S. Census Bureau (Ed.), Statistical abstract of the United States: 2012: Section 1: Population. Retrieved from
  15. 15.
    U.S. Census Bureau. (2017). Annual estimates of the resident population: April 1, 2010 to July 1, 2017: 2017 Population estimates. In U.S. Census Bureau (Ed.), American FactFinder. Retrieved from
  16. 16.
    Center for Mental Health Services, Substance Abuse and Mental Health Services Administration. (2006). Mental health, United States, 2004 (DHHS Publication No. [SMA]-06-4195). Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration. Retrieved from
  17. 17.
    Substance Abuse and Mental Health Services Administration. (2010). Mental health, United States, 2008 (HHS Publication No. [SMA] 10-4590). Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration. Retrieved from
  18. 18.
    Substance Abuse and Mental Health Services Administration. (2014). Figure 2.9: Facilities offering programs for individuals with co-occurring mental health and substance abuse disorders, by facility type: 2010. In Substance Abuse and Mental Health Services Administration (Ed.), National Mental Health Services Survey (N-MHSS): 2010 data on mental health treatment facilities (BHSIS Series S-69, HHS Publication No. [SMA] 14-4837). Rockville, MD: Substance Abuse and Mental Health Services Administration. Retrieved from
  19. 19.
    Substance Abuse and Mental Health Services Administration. (2016). Figure 2.10: Facilities offering programs for individuals with co-occurring mental health and substance use disorders, by facility type: 2014. In Substance Abuse and Mental Health Services Administration (Ed.), National Mental Health Services Survey (N-MHSS): 2014 data on mental health treatment facilities (BHSIS Series S-87, HHS Publication No. [SMA] 16-5000). Rockville, MD: Substance Abuse and Mental Health Services Administration. Retrieved from
  20. 20.
    Hafner, H. (1987). Do we still need beds for psychiatric patients? An analysis of changing patterns of mental health care. Acta Psychiatrica Scandinavica, 75(2), 113–126.CrossRefGoogle Scholar
  21. 21.
    Torrey, E. F. (2016). A dearth of psychiatric beds. Psychiatric Times, 33(2). Retrieved from
  22. 22.
    Alakeson, V., Pande, N., & Ludwig, M. (2010). A plan to reduce emergency room ‘boarding’ of psychiatric patients. Health Affairs, 29(9), 1637–1642. Scholar
  23. 23.
    Henneman, P. L., Nathanson, B. H., Li, H., Smithline, H. A., Blank, F. S., Santoro, J. P., … Henneman, E. A. (2010). Emergency department patients who stay more than 6 hours contribute to crowding. Journal of Emergency Medicine, 39(1), 105–112.
  24. 24.
    Chang, G., Weiss, A., Kosowsky, J. M., Orav, E. J., Smallwood, J. A., & Rauch, S. L. (2012). Characteristics of adult psychiatric patients with stays of 24 hours or more in the emergency department. Psychiatric Services, 63(3), 283–286. Scholar
  25. 25.
    Chang, G., Weiss, A. P., Orav, E. J., Smallwood, J. A., Gonzalez, S., Kosowsky, J. M., & Rauch, S. L. (2012). Bottlenecks in the emergency department: The psychiatric clinicians’ perspective. General Hospital Psychiatry, 34(4), 403–409.
  26. 26.
    Swartz, M. S. (2016). Emergency department boarding: Nowhere else to go. Psychiatric Services, 67(11), 1163. Scholar
  27. 27.
    Dartmouth Institute for Health Policy and Clinical Practice. (2018). Data by region. Dartmouth atlas of health care. Retrieved from
  28. 28.
    Frank, R. G., & Garfield, R. L. (2007). Managed behavioral health care carve-outs: Past performance and future prospects. Annual Review of Public Health, 28, 303–320. Scholar
  29. 29.
    Mowbray, C. T., Grazier, K. L., & Holter, M. (2002). Managed behavioral health care in the public sector: Will it become the third shame of the states? Psychiatric Services, 53(2), 157–170. Scholar
  30. 30.
    Cromwell, J., Drozd, E. M., Gage, B., Maier, J., Richter, E., & Goldman, H. H. (2005). Variation in patient routine costliness in U.S. psychiatric facilities. Journal of Mental Health Policy and Economics, 8(1), 15–28.Google Scholar
  31. 31.
    Drozd, E. M., Cromwell, J., Gage, B., Maier, J., Greenwald, L. M., & Goldman, H. H. (2006). Patient casemix classification for Medicare psychiatric prospective payment. American Journal of Psychiatry, 163(4), 724–732. Scholar
  32. 32.
    Drozd, E. M., Maier, J., Hales, J. F., & Thomas, F. G. (2008). Alternative comorbidity adjustors for the Medicare inpatient psychiatric facility PPS. Health Care Financing Review, 30(2), 67–82.Google Scholar
  33. 33.
    Rajkumar, R., Patel, A., Murphy, K., Colmers, J. M., Blum, J. D., Conway, P. H., & Sharfstein, J. M. (2014). Maryland’s all-payer approach to delivery-system reform. New England Journal of Medicine, 370(6), 493–495.
  34. 34.
    Hurst, J. W. (1991). Reforming health care in seven European nations. Health Affairs, 10(3), 7–21.CrossRefGoogle Scholar
  35. 35.
    Slade, E. P., & Goldman, H. H. (2015). The dynamics of psychiatric bed use in general hospitals. Administration and Policy in Mental Health, 42(2), 139–146. Scholar
  36. 36.
    Goldman, H. H., Taube, C. A., Regier, D. A., & Witkin, M. (1983). The multiple functions of the state mental hospital. American Journal of Psychiatry, 140(3), 296–300. Scholar
  37. 37.
    Rothbard, A. B., Schinnar, A. P., & Goldman, H. (1996). The pursuit of a definition for severe and persistent mental illness. In S. M. Soreff (Ed.), Handbook for the treatment of the seriously mentally ill (pp. 9–26). Ashland, OH: Hogrefe & Huber.Google Scholar
  38. 38.
    Goldman, H. H., Gattozzi, A. A., & Taube, C. A. (1981). Defining and counting the chronically mentally ill. Hospital & Community Psychiatry, 32(1), 21–27.Google Scholar
  39. 39.
    Herman, D. B., Conover, S., Gorroochurn, P., Hinterland, K., Hoepner, L., & Susser, E. S. (2011). Randomized trial of critical time intervention to prevent homelessness after hospital discharge. Psychiatric Services, 62(7), 713–719. Scholar
  40. 40.
    Lyketsos, C. G., Dunn, G., Kaminsky, M. J., & Breakey, W. R. (2002). Medical comorbidity in psychiatric inpatients: Relation to clinical outcomes and hospital length of stay. Psychosomatics, 43(1), 24–30. Scholar
  41. 41.
    Santos, A. B., Henggeler, S. W., Burns, B. J., Arana, G. W., & Meisler, N. (1995). Research on field-based services: Models for reform in the delivery of mental health care to populations with complex clinical problems. American Journal of Psychiatry, 152(8), 1111–1123. Scholar
  42. 42.
    Sharfstein, S. S., & Dickerson, F. B. (2009). Hospital psychiatry for the twenty-first century. Health Affairs, 28(3), 685–688. Scholar
  43. 43.
    Olfson, M., Wall, M., Wang, S., Crystal, S., Gerhard, T., & Blanco, C. (2017). Suicide following deliberate self-harm. American Journal of Psychiatry, 174(8), 765–774. Scholar
  44. 44.
    Hankin, C. S., Bronstone, A., & Koran, L. M. (2011). Agitation in the inpatient psychiatric setting: A review of clinical presentation, burden, and treatment. Journal of Psychiatric Practice, 17(3), 170–185. Scholar
  45. 45.
    Lanier, P., & Rose, R. A. (2017). Admission to psychiatric residential treatment facilities among youth from families investigated for maltreatment. Journal of Child and Family Studies, 26(1), 306–316. Scholar
  46. 46.
    Williams, N. J., Scott, L., & Aarons, G. A. (2017). Prevalence of serious emotional disturbance among U.S. children: A meta-analysis. Psychiatric Services.
  47. 47.
    Costello, E. J., He, J. P., Sampson, N. A., Kessler, R. C., & Merikangas, K. R. (2014). Services for adolescents with psychiatric disorders: 12-month data from the National Comorbidity Survey-Adolescent. Psychiatric Services, 65(3), 359–366. Scholar
  48. 48.
    Goplerud, E. N. (1986). Assessing methods of predicting the need for psychiatric beds. Hospital & Community Psychiatry, 37(4), 391–395.Google Scholar
  49. 49.
    Trye, P., Murray, N., Wolstencroft, I., & Stewart, A. (2002). Health service capacity modelling. Australian Health Review, 25(4), 159–168.CrossRefGoogle Scholar
  50. 50.
    La, E. M., Lich, K. H., Wells, R., Ellis, A. R., Swartz, M. S., Zhu, R., & Morrissey, J. P. (2016). Increasing access to state psychiatric hospital beds: Exploring supply-side solutions. Psychiatric Services, 67(5), 523–528.
  51. 51.
    Centers for Medicare & Medicaid Services. (2017). Inpatient Psychiatric Facility Prospective Payment System (IPFPPS) PC PRICER. Retrieved from
  52. 52.
    Russakoff, L. M. (2014). Private in-patient psychiatry in the USA. Psychiatric Bulletin, 38(5), 230–235.
  53. 53.
    Goldman, W., McCulloch, J., & Sturm, R. (1998). Costs and use of mental health services before and after managed care. Health Affairs, 17(2), 40–52.CrossRefGoogle Scholar
  54. 54.
    National Council for Behavioral Health. (2017). The psychiatric shortage: Causes and solutions. Washington, DC: National Council for Behavioral Health. Retrieved from
  55. 55.
    Thomas, K., Ellis, A., Konrad, T., Holzer, C., & Morrissey, J. (2009). County-level estimates of mental health professional shortage in the Unites States. Psychiatric Services, 60(10), 1323–1328.CrossRefGoogle Scholar
  56. 56.
    Domino, M. E., Lin, C. C., Morrissey, J., Ellis, A. R., Fraher, E., Gaul, K., … Thomas, K. (2016). The psychologist workforce in North Carolina: Expanding access for patients in rural areas. Chapel Hill, NC: Cecil G. Sheps Center for Health Services Research. Retrieved from
  57. 57.
    Centers for Medicare & Medicaid Services. (2017). The Mental Health Parity and Addiction Equity Act (MHPAEA). Retrieved from
  58. 58.
    Irvin, C. V., Denny-Brown, N., Bohl, A., Schurrer, J., Wysocki, A., Coughlin, R., & Williams, S. R. (2015). Money follows the person 2014 annual evaluation report. Cambridge, MA: Mathematica Policy Research. Retrieved from
  59. 59.
    West, J. C. (2014). Emtala obligations for psychiatric patients. Journal of Healthcare Risk Management, 34(2), 5–12. Scholar
  60. 60.
    Nolan, J. M., Fee, C., Cooper, B. A., Rankin, S. H., & Blegen, M. A. (2015). Psychiatric boarding incidence, duration, and associated factors in United States emergency departments. Journal of Emergency Nursing, 41(1), 57–64. Scholar
  61. 61.
    Evans, M. (2016). Behind Medicaid’s move to pay psychiatric hospitals. Modern Healthcare, 46(7), 22–24.Google Scholar
  62. 62.
    Dickson, V. (2017). Providers feel the pain of slow Medicaid mental services rule rollout. Modern Healthcare, 47(35), 18.Google Scholar
  63. 63.
    Substance Abuse and Mental Health Services Administration. (2017). National Mental Health Services Survey (N-MHSS): 2016 data on mental health treatment facilities (BHSIS Series S-98, HHS Publication No. [SMA] 17-5049). Rockville, MD: Substance Abuse and Mental Health Services Administration. Retrieved from
  64. 64.
    Medicare Payment Advisory Commission. (2017). A data book: Health care spending and the Medicare program. Washington, DC: Medicare Payment Advisory Commission. Retrieved from
  65. 65.
    Tanzman, B. (1993). An overview of surveys of mental health consumers’ preferences for housing and support services. Hospital & Community Psychiatry, 44(5), 450–455.Google Scholar
  66. 66.
    Holley, H. L., Hodges, P., & Jeffers, B. (1998). Moving psychiatric patients from hospital to community: Views of patients, providers, and families. Psychiatric Services, 49(4), 513–517. Scholar
  67. 67.
    Brown, J. F. (2007). A survey of emergency department psychiatric services. General Hospital Psychiatry, 29(6), 475–480. Scholar
  68. 68.
    Substance Abuse and Mental Health Services Administration. (2014). Projections of national expenditures for treatment of mental and substance use disorders, 2010–2020 (HHS Publication No. SMA-14-4883). Rockville, MD: Substance Abuse and Mental Health Services Administration. Retrieved from
  69. 69.
    Schwalbe, L. (2010). Behavioral health providers: Expenditures, methods and sources of payment, electronic health record incentive payments for certain behavioral health providers policy descriptions. Washington, DC: Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services. Retrieved from
  70. 70.
    Slade, E. P., Goldman, H. H., Dixon, L. B., Gibbons, B., & Stuart, E. A. (2015). Assessing the representativeness of Medical Expenditure Panel Survey inpatient utilization data for individuals with psychiatric and nonpsychiatric conditions. Medical Care Research and Review, 72(6), 736–755. Scholar
  71. 71.
    Centers for Medicare & Medicaid Services. (2016). Medicaid managed care enrollment and program characteristics, 2014. Cambridge, MA: Mathematica Policy Research. Retrieved from
  72. 72.
    Bloom, J., Hu, T.-W., Wallace, N., Cuffel, B., Hausman, J., Sheu, M.-L., & Scheffler, R. (2002). Mental health costs and access under alternative capitation systems in Colorado. Health Services Research, 37(2), 315–340.
  73. 73.
    Catalano, R., Libby, A., Snowden, L., & Cuellar, A. E. (2000). The effect of capitated financing on mental health services for children and youth: The Colorado experience. American Journal of Public Health, 90(12), 1861–1865.CrossRefGoogle Scholar
  74. 74.
    Stoner, T., Manning, W., Christianson, J., Gray, D., & Marriott, S. (1997). Expenditures for mental health services in the Utah prepaid mental health plan. Health Care Financing Review, 18(3), 73–93.Google Scholar
  75. 75.
    Zeller, S., Calma, N., & Stone, A. (2014). Effects of a dedicated regional psychiatric emergency service on boarding of psychiatric patients in area emergency eepartments. Western Journal of Emergency Medicine, 15(1), 1–6. Scholar
  76. 76.
    Wright, B., Jung, H.-Y., Feng, Z., & Mor, V. (2013). Trends in observation care among Medicare fee-for-service beneficiaries at critical access hospitals, 2007–2009. The Journal of Rural Health: Official Journal of the American Rural Health Association and the National Rural Health Care Association, 29(1), s1–s6.
  77. 77.
    Mechanic, D. (2014). More people than ever before are receiving behavioral health care in the United States, but gaps and challenges remain. Health Affairs, 33(8), 1416–1424. Scholar
  78. 78.
    Bao, Y., & Sturm, R. (2001). How do trends for behavioral health inpatient care differ from medical inpatient care in U.S. community hospitals? Journal of Mental Health Policy and Economics, 4(2), 55–63.Google Scholar
  79. 79.
    Burns, B. J., & Santos, A. B. (1995). Assertive community treatment: An update of randomized trials. Psychiatric Services, 46(7), 669–675. Scholar
  80. 80.
    Herdelin, A. C., & Scott, D. (1999). Experimental studies of the Program of Assertive Community Treatment (PACT): A meta-analysis. Journal of Disability Policy Studies, 10(1), 53–89. Scholar
  81. 81.
    Marshall, M., & Lockwood, A. (2000). Assertive community treatment for people with severe mental disorders. Cochrane Database of Systematic Reviews (2), CD001089.
  82. 82.
    Latimer, E. A. (1999). Economic impacts of assertive community treatment: A review of the literature. Canadian Journal of Psychiatry, 44(5), 443–454. Scholar
  83. 83.
    Morrissey, J. P., Domino, M. E., & Cuddeback, G. S. (2013). Assessing the effectiveness of recovery-oriented ACT in reducing state psychiatric hospital use. Psychiatric Services, 64(4), 303–311. Scholar
  84. 84.
    Marshall, M., Gray, A., Lockwood, A., & Green, R. (2000). Case management for people with severe mental disorders. Cochrane Database of Systematic Reviews (2), CD000050.
  85. 85.
    Dieterich, M., Irving, C. B., Park, B., & Marshall, M. (2010). Intensive case management for severe mental illness. Cochrane Database of Systematic Reviews (10), CD007906.
  86. 86.
    Rog, D., Marshall, T., Dougherty, R. H., George, P., Daniels, A. S., Ghose, S. S., & Delphin-Rittmon, M. E. (2014). Permanent supportive housing: Assessing the evidence. Psychiatric Services, 65(3), 287–294.
  87. 87.
    Murphy, S., Irving, C. B., Adams, C. E., & Driver, R. (2012). Crisis intervention for people with severe mental illnesses. Cochrane Database of Systematic Reviews (5), CD001087-CD87.
  88. 88.
    Morrissey, J. P., Desmarais, S. L., & Domino, M. E. (2014). Outpatient commitment and its alternatives: Questions yet to be answered. Psychiatric Services, 65(6), 812–815. Scholar
  89. 89.
    Burns, T., Rugkasa, J., Molodynski, A., Dawson, J., Yeeles, K., Vazquez-Montes, M., … Priebe, S. (2013). Community treatment orders for patients with psychosis (OCTET): A randomised controlled trial. Lancet, 381(9878), 1627–1633.
  90. 90.
    Segal, S. P., & Burgess, P. M. (2006). Conditional release: A less restrictive alternative to hospitalization? Psychiatric Services, 57(11), 1600–1606. Scholar
  91. 91.
    Segal, S. P., & Burgess, P. M. (2008). Use of community treatment orders to prevent psychiatric hospitalization. Australian and New Zealand Journal of Psychiatry, 42(8), 732–739. Scholar
  92. 92.
    Beadles, C. A., Ellis, A. R., Lichstein, J. C., Farley, J. F., Jackson, C. T., Morrissey, J. P., & Domino, M. E. (2015). First outpatient follow-up after psychiatric hospitalization: Does one size fit all? Psychiatric Services, 66(4), 364–372.
  93. 93.
    Sledge, W. H., Lawless, M., Sells, D., Wieland, M., O’Connell, M. J., & Davidson, L. (2011). Effectiveness of peer support in reducing readmissions of persons with multiple psychiatric hospitalizations. Psychiatric Services, 62(5), 541–544. Scholar
  94. 94.
    Meara, E., Golberstein, E., Zaha, R., Greenfield, S. F., Beardslee, W. R., & Busch, S. H. (2014). Use of hospital-based services among young adults with behavioral health diagnoses before and after health insurance expansions. JAMA Psychiatry, 71(4), 404–411. Scholar
  95. 95.
    Golberstein, E., Busch, S. H., Zaha, R., Greenfield, S. F., Beardslee, W. R., & Meara, E. (2015). Effect of the Affordable Care Act’s young adult insurance expansions on hospital-based mental health care. American Journal of Psychiatry, 172(2), 182–189. Scholar
  96. 96.
    Morrissey, J. P., Domino, M. E., & Cuddeback, G. S. (2016). Expedited Medicaid enrollment, mental health service use, and criminal recidivism among released prisoners with severe mental illness. Psychiatric Services, 67(8), 842–849. Scholar
  97. 97.
    Herrera, C.-N., Hargraves, J., & Stanton, G. (2013). The impact of the Mental Health Parity and Addiction Equity Act on inpatient admissions (Issue Brief No. 5). Washington, DC: Health Care Cost Institute. Retrieved from
  98. 98.
    Ettner, S. L., Harwood, M., Thalmayer, A., Ong, M. K., Xu, H., Bresolin, M. J., … Azocar, F. (2016). The Mental Health Parity and Addiction Equity Act evaluation study: Impact on specialty behavioral health utilization and expenditures among “carve-out” enrollees. Journal of Health Economics, 50, 131–143.
  99. 99.
    Mark, T. L., Vandivort-Warren, R., & Miller, K. (2012). Mental health spending by private insurance: Implications for the Mental Health Parity and Addiction Equity Act. Psychiatric Services, 63(4), 313–318. Scholar
  100. 100.
    Blyler, C., Azur, M., O’Day, B., Anand, P., Barrett, A., Choudhry, K., … Zivin, K. (2016). Medicaid emergency psychiatric services demonstration evaluation: Final report (Vol. 1). Cambridge, MA: Mathematica Policy Research. Retrieved from
  101. 101.
    Rutter, C. M., Zaslavsky, A. M., & Feuer, E. J. (2011). Dynamic microsimulation models for health outcomes: A review. Medical Decision Making, 31(1), 10–18. Scholar
  102. 102.
    Stahl, J. E. (2008). Modelling methods for pharmacoeconomics and health technology assessment: An overview and guide. Pharmacoeconomics, 26(2), 131–148.CrossRefGoogle Scholar
  103. 103.
    Borshchev, A., & Filippov, A. (2004). From system dynamics and discrete event to practical agent based modeling: Reasons, techniques, tools. Paper presented at the the 22nd International Conference of the System Dynamics Society, Oxford, UK. Retrieved from
  104. 104.
    Hooten, M. B., & Wikle, C. K. (2010). Statistical agent-based models for discrete spatio-temporal systems. Journal of the American Statistical Association, 105(489), 236–248. Scholar
  105. 105.
    Treatment Advocacy Center. (2014). How many individuals with serious mental illness are in jails and prisons? [Fact sheet]. Retrieved from

Copyright information

© The Author(s) 2020

Authors and Affiliations

  • Eric Slade
    • 1
  • Marisa Elena Domino
    • 2
  1. 1.Johns Hopkins School of NursingBaltimoreUSA
  2. 2.Department of Health Policy and Management, Gillings School of Global Public Health and Cecil G. Sheps Center for Health Services ResearchUniversity of North CarolinaChapel HillUSA

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