Youth Inpatient and Residential Treatment Psychiatric Beds: National Trends and Potential Causal Factors, 2010-2022.

Abstract

Objective: Youth inpatient and residential treatment psychiatric services are essential components of the continuum of care. Concern has grown about the diminished availability of these services and the increasing need for them. This study aimed to examine the number of youths treated at inpatient and residential psychiatric facilities over a 12-year period and to assess the perceptions of state mental health authorities (SMHAs) about the reasons for changes in availability.

Methods: In this multimodal study, the authors conducted a secondary analysis of a national survey (including all 50 states, Washington, D.C., and Puerto Rico) of mental health facilities that was administered seven times between 2010 and 2022. In addition, the study relied on 2023 data from a survey of SMHAs (N=34 respondents).

Results: Most states experienced a decline in the number of youths in inpatient (79%) and residential treatment psychiatric facilities (94%). Although some people posit that increased use of outpatient services may explain such declines, 81% of states had a reduction in community outpatient psychiatric care for youths during the study period. SMHAs reported that the impact of the COVID-19 pandemic and preexisting workforce shortages contributed to the reduction of youths treated.

Conclusions: These findings show a nationwide decline in the number of youths treated in inpatient and residential treatment psychiatric facilities over time. Determining causal factors in these declines is challenging, and it is critical to develop a monitoring and reporting system for the number of youths requiring services and the capacity within each state for addressing youth needs.