The number of psychiatric hospitals in the United States is difficult to determine due to the complex nature of the mental healthcare infrastructure. Unlike general medical facilities, psychiatric care is delivered across various settings counted differently by government and private organizations. Understanding the current count requires defining what constitutes a “psychiatric hospital” and acknowledging the different ways inpatient care is delivered.
Defining the Scope of Psychiatric Care Facilities
The term “psychiatric hospital” generally refers to a facility dedicated solely to providing inpatient mental health treatment. These facilities include state-run psychiatric facilities, which often focus on long-term or forensic care, and private, freestanding psychiatric hospitals. However, a significant portion of acute inpatient mental healthcare is provided within psychiatric units located inside general medical and surgical hospitals.
These psychiatric units function as distinct, staffed departments providing overnight care for mental health clients. They are not counted as separate hospitals but contribute substantially to the nation’s total capacity for inpatient stabilization and treatment. Organizations like the Substance Abuse and Mental Health Services Administration (SAMHSA) track both dedicated psychiatric hospitals and these units under the category of 24-hour Hospital Inpatient Facilities.
Current National Count and Capacity
While the exact number fluctuates, one estimate placed the count of active, dedicated psychiatric hospitals in the U.S. at approximately 820 as of early 2023. This count represents facilities whose primary function is mental health inpatient treatment. However, the more illustrative metric of the nation’s capacity is the total number of inpatient psychiatric beds (IPBs).
Data from the Centers for Medicare and Medicaid Services (CMS) reveals that the total number of IPBs per 100,000 persons remained relatively stable between 2011 and 2023, hovering around 28.4 beds per 100,000 people. This stability masks a significant internal shift in where care is being provided.
During this period, the number of IPBs located within dedicated psychiatric hospitals increased from 16.8 to 19.5 per 100,000 persons. Conversely, the number of IPBs located in psychiatric units within short-term acute care hospitals (STACHs) decreased from 11.2 to 8.9 per 100,000 persons. This trend indicates that while overall capacity has stabilized, the infrastructure is shifting away from general hospital units toward freestanding psychiatric hospitals, which are often private or for-profit entities.
Historical Context of Psychiatric Hospital Count
The current capacity is a small fraction of the infrastructure that existed in the mid-20th century. The peak year for psychiatric hospitalization occurred in 1955, when the total number of psychiatric beds across the country exceeded 500,000. At that time, state psychiatric hospitals alone held over half a million patients, representing a massive public infrastructure for long-term care.
A massive shift, often termed deinstitutionalization, began in the 1960s and 1970s, fueled by new psychotropic medications, civil rights movements, and federal policy changes like the introduction of Medicaid. Between 1970 and 2014, the resident population in state psychiatric hospitals saw a dramatic decline, dropping from approximately 370,000 to just 40,000. This decline represents a reduction of over 500,000 beds from the peak, fundamentally changing the landscape of mental healthcare delivery. The intention was to shift care to community-based settings, but the infrastructure for community care often did not keep pace with the closures.
Geographic Distribution and Access Disparities
The national count of hospitals and beds does not reflect uniform access across the country. Psychiatric facilities and their corresponding beds are heavily concentrated in certain areas, leading to significant geographic disparities in care access. Over half of all counties in the United States do not have any mental health providers, including psychiatric hospitals.
This lack of infrastructure creates “psychiatric deserts,” particularly in rural and underserved regions. For example, in 2023, nearly 1,449 counties across the U.S. had no available inpatient psychiatric beds. The uneven distribution of resources is highlighted by data showing “hot spots” for inpatient stays for conditions like depression and schizophrenia in regions like Appalachia and parts of the South and Midwest. This geographical clustering suggests that high-need areas often have the fewest resources, leading to delayed treatment and increased reliance on emergency rooms for crisis stabilization.