CalMHSA: Evaluation of California's Statewide Mental Health Prevention and Early Intervention Initiatives
Nov 30, 2022
In California, Merced, San Joaquin, and Stanislaus Counties sought to understand the gap between capacity and need for psychiatric and substance use disorder beds. This report estimates bed shortages by triangulating estimates through various data sets, literature review findings, and facility survey responses. The authors use these estimates to inform their recommendations to these counties for improving access to behavioral health care.
Psychiatric and substance use disorder (SUD) treatment beds are essential infrastructure for meeting the needs of individuals with behavioral health conditions. However, not all psychiatric and SUD beds are alike: They represent infrastructure within different types of facilities. For psychiatric beds, these vary from acute psychiatric hospitals to community residential facilities. For SUD treatment beds, these vary from facilities offering short-term withdrawal management services to others offering longer duration residential detoxification services. Different settings also serve clients with different needs. For example, some clients have high-acuity, short-term needs; others have longer-term needs and may return for care on multiple occasions.
California's Merced, San Joaquin, and Stanislaus Counties, like other counties throughout the United States, have sought to assess shortages in psychiatric and SUD treatment beds. In this report, the authors estimated psychiatric bed and residential SUD treatment capacity, need, and shortages for adults and children and adolescents at various levels of care: acute, subacute, and community residential services for psychiatric treatment and SUD treatment service categories defined by American Society of Addiction Medicine clinical guidelines.
Drawing from various data sets, literature review findings, and facility survey responses, the authors computed the number of beds required — at each level of care — for adults and children and adolescents and identified hard-to-place populations. The authors draw from these findings to offer Merced, San Joaquin, and Stanislaus Counties recommendations to help ensure all their residents, especially nonambulatory individuals, have access to the behavioral health care that they need.