October 25, 2017

Adding Additional Psychiatric Beds Not Enough to Reduce Impacts of Serious Mental Illness

A new report finds that an interconnected, evidence-based system of care is necessary if the human and economic costs associated with severe mental illness are to be reduced. 

Debrah Pinals, M.D., clinical professor of psychiatry and director of the U-M Program in Psychiatry, Law and Ethics co-authored a new report titled, "Beyond Beds: The Vital Role of a Full Continuum of Psychiatric Care." The report was issued by The National Association of Mental Health Program Directors and The Treatment Advocacy Center, read the original press release here:


An interconnected, evidence-based system of care is necessary if the human and economic costs associated with severe mental illness are to be reduced, according to Beyond Beds: The Vital Role of a Full Continuum of Psychiatric Care, a new joint report issued today by the National Association of State Mental Health Directors (NASMHPD) and the Treatment Advocacy Center.

“We are overdue to treat serious mental illness as we treat other medical conditions,” said Brian Hepburn, MD, executive director of NASMHPD, a member organization of the nation’s top state mental health officials. “Until we recognize and address these diseases with the same spectrum of outpatient and residential care that is routinely extended to other chronic and life-threatening medical conditions, individuals, families and communities will suffer needlessly.”

The study makes 10 recommendations to policymakers for laying the foundation for improving the treatment system. Among them are prioritizing development of a full continuum of psychiatric care, improving diversion of individuals with mental illness from the criminal justice system to the treatment system, penalizing hospitals whose emergency rooms treat psychiatric patients differently from other medical patients and identifying public policies that act as disincentives for operating needed psychiatric beds.


“This report is a valuable contribution to our efforts to ensure sufficient treatment capacity to meet the acute, intermediate and long-term needs of individuals with mental illness," said Elinore McCance-Katz, MD, Assistant Secretary for Mental Health and Substance Use at the US Department of Health and Human Services. Dr. McCance-Katz leads the Substance Abuse and Mental Health Services Administration, which provided funding for the project.

Both NASMHPD and the Treatment Advocacy Center have consistently supported the vital role of psychiatric hospital beds for individuals with serious mental illness. In Beyond Beds, the organizations build on that important message to detail the different types of beds necessary to a functioning mental health system and describe how such beds fit into a comprehensive system of care that reduces negative consequences of untreated and undertreated serious mental illness.

Beyond Beds is the introduction to nine technical reports from NASMHPD on aspects of a full continuum of psychiatric care. “Too often families confront overwhelming challenges when seeking psychiatric care for a loved one with a serious mental illness,” said John Snook, executive director for the Treatment Advocacy Center. “This report and the ones that follow help to provide a roadmap for what a functioning system could look like, and details how providing a full continuum of services, including psychiatric hospital beds, could dramatically improve our current system of care.”

Nearly 10 million US adults are estimated to live with a diagnosable psychiatric condition sufficiently serious to impair their personal, social and economic functioning. Approximately half are untreated in any given year, according to the National Institute of Mental Health. Beyond Beds is grounded in the premise that people with serious mental illness deserve access to the same levels of care as individuals with other medical conditions.

Beyond Beds is co-authored by Debra A. Pinals, MD, Michigan’s medical director of Behavioral Health and Forensic Programs and who is also a clinical professor of psychiatry for the University of Michigan. Dr. Pinals contributes the perspective of an experienced mental health official, and Doris A. Fuller, the second co-author, who has been a professional mental illness treatment advocate as a Treatment Advocacy Center executive and a personal advocate as the mother of a young adult with serious mental illness.


The National Association of Mental Health Program Directors is a member organization representing state executives responsible for the $41 billion public mental health service delivery system in the United States.

The Treatment Advocacy Center is a national non-profit organization dedicated to eliminating barriers to the timely and effective treatment of severe mental illness by promoting laws, policies and practices for improved delivery of psychiatric care for severe and persistent psychiatric illnesses, such as schizophrenia and bipolar disorder.