Minimum and optimal numbers of psychiatric beds: expert consensus using a Delphi process.

Area of Science:

• Mental Health Services Research
• Health Policy and Planning
• Global Psychiatry

Background:

• The optimal number of psychiatric inpatient beds is a critical, debated issue with significant resource implications.
• Current psychiatric bed provision varies widely globally, particularly between high-income countries (HICs) and low- and middle-income countries (LMICs).

Purpose of the Study:

• To establish a global expert consensus on the minimum and optimal number of psychiatric beds per capita.
• To define thresholds for mild, moderate, and severe psychiatric bed shortages.

Main Methods:

• Utilized the Delphi method, an expert consensus technique, involving two rounds of responses.
• A diverse international panel of 65 experts from 40 countries, representing HICs and LMICs, was convened.
• Experts provided and refined estimates for minimum, optimal, and shortage levels of psychiatric beds.

Main Results:

• Consensus was reached: 60 psychiatric beds per 100,000 population is optimal, and 30 beds per 100,000 is the minimum.
• Mild shortage defined as 25-30 beds, moderate as 15-25, and severe as less than 15 beds per 100,000.
• Many LMICs currently operate below the recommended minimum psychiatric bed rate.

Conclusions:

• This study provides the first expert-driven global consensus on psychiatric bed number recommendations.
• Findings highlight significant disparities in psychiatric bed availability, with LMICs facing critical shortages.
• The established benchmarks can inform health policy and resource allocation for mental healthcare globally.