Rise of Psychiatric Beds in For-Profit Chains Amid Decline at Public Hospitals
A new study shows that while total inpatient psychiatric beds remain stable, the ownership and location have shifted heavily toward large for-profit chains, raising questions about care quality and safety.
Recent research from Columbia University Mailman School of Public Health and Johns Hopkins Bloomberg School of Public Health reveals a significant shift in inpatient psychiatric care in the United States. Although the overall number of psychiatric beds has remained relatively stable from 2011 to 2023, there has been a notable redistribution in their locations and ownership. Specifically, beds at general hospitals have decreased, while standalone psychiatric facilities—particularly those owned by large for-profit chains—have experienced a substantial increase.
The study highlights that the proportion of psychiatric beds in standalone facilities offering only psychiatric care grew from 65% to 74% over the 12-year period. Ownership patterns shifted drastically: in 2011, only 11% of these beds were owned by large for-profit hospital groups, but by 2023, this figure doubled to 27%. Meanwhile, government-owned beds declined from 64% to 48%.
Experts suggest that this trend toward specialized psychiatric hospitals owned by for-profit entities raises important questions about patient safety and quality of care. While specialized hospitals could provide more tailored psychiatric services, there have been concerns regarding safety and the quality standards maintained by some large chains.
The analysis was based on data from the Healthcare Cost Report Information System and the American Hospital Association's Annual Survey. Findings indicate that the growth in for-profit psychiatric chains is part of a broader, ongoing shift in how psychiatric care is delivered in the country—an evolution that does not seem solely driven by policies like the Affordable Care Act or mental health parity laws.
This transformation in psychiatric bed distribution underscores the need for further research to ensure that high-quality, safe, and accessible mental health services are maintained. The study's co-authors include experts from Columbia University and Johns Hopkins, emphasizing the importance of continuous monitoring of mental health infrastructure to meet the growing demands of the population.
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