JAMA Psychiatry

Bedless Psychiatry—Rebuilding Behavioral Health Service Capacity

In 1939, the geneticist and psychiatrist Lionel Penrose first offered his hypothesis that the number of psychiatric beds was inversely associated with the incarceration rate of individuals with mental illness. Since then, the answer to the question “How many psychiatric hospital beds do developed nations need?” remains controversial and unclear. In the United States during the era of asylum psychiatry, the answer was many, very many, beds. By 1955, the United States reached the apex of asylum psychiatry, with more than 550 000 individuals in psychiatric hospitals.