Beyond Beds: The Vital Role of a Full Continuum of Psychiatric Care

Beyond Beds is a joint report with the National Association of State Mental Health Program Directors and represents the introductory
paper in a 10-part series on the inpatient psychiatric treatment capacity in the United States.

Summary
Nearly 10 million individuals in the United States are estimated to live with a diagnosable psychiatric condition sufficiently serious to impair their personal, social and economic functioning. Hardly a day goes by without a study, headline, court case or legislative action calling for reform of the mental health system to better serve this population. Often, these calls to action end in two words: “More beds.”

What is largely missing from the outcry are answers to broader questions like, “What do we mean by ‘beds?” More precisely defined, what types of beds are needed: acute, transitional, rehabilitative, long-term or other? Are there differences in the needs of different age groups–youth, adults, older persons–and diagnoses that need to be reflected in the bed composition? What are the evidence-based outpatient practices that would reduce bed demand by reducing the likelihood of crisis developing or by diverting individuals in crisis to appropriate settings outside of hospitals?

Beyond Beds: The Vital Role of a Full Continuum of Psychiatric Care addresses these questions and offers 10 public policy recommendations for reducing the human and economic costs associated with severe mental illness by building and invigorating a robust, interconnected, evidence-based system of care that goes beyond beds. Each recommendation is drawn from data and observation and is illustrated by the story of Taylor, a representative young adult whose journey toward mental health recovery illustrates both the failings and the potential of the current continuum of psychiatric care.