The question of how many psychiatric hospitals exist in the United States is complicated, primarily due to how different facilities are classified and counted. The true number is not a single figure but a collection of statistics reflecting a diverse mental health care infrastructure. Understanding this requires looking beyond just freestanding hospitals to include psychiatric units operating within general medical facilities. The system includes everything from large state-run institutions to small, specialized private clinics, all providing varying levels of inpatient care.
The Current Count of Dedicated Psychiatric Facilities
The most current statistical answer points to an approximate figure for dedicated mental health facilities. As of 2022, the Substance Abuse and Mental Health Services Administration (SAMHSA) reported approximately 1,221 psychiatric hospitals and facilities providing a range of inpatient and outpatient services across the U.S. This count typically includes freestanding inpatient hospitals that exclusively focus on psychiatric care.
This baseline number establishes the count of facilities dedicated solely to mental health treatment. Freestanding psychiatric hospitals often provide specialized services for conditions like severe mental illnesses, substance use disorders, or eating disorders. However, this figure does not capture the complete inpatient capacity available nationwide.
The count generally focuses on facilities where the entire institution is designated as a psychiatric hospital. It often excludes a significant portion of acute psychiatric care capacity found in general hospitals. This exclusion is a major reason why relying on the single number of dedicated facilities can be misleading when assessing total resources.
Categorizing Behavioral Health Institutions
The total capacity for psychiatric care is scattered across several distinct types of institutions, making a single count misleading. State and county mental health hospitals represent the oldest form of care, historically serving long-term and forensic patient populations. While these facilities have experienced a substantial decline since the mid-20th century, 192 state-operated psychiatric hospitals were reported in 2023. These facilities often manage patients requiring extended care or those involved in the criminal justice system.
A growing segment of the infrastructure includes private and for-profit psychiatric hospitals, which often focus on short-term stabilization and acute care. These facilities have seen growth in capacity, particularly as state hospital capacity has contracted. They often cater to a specialized patient population and have shorter lengths of stay compared to state-run facilities.
A crucial distinction is the role of psychiatric units within general hospitals, also known as short-term acute care hospitals (STACHs). These units handle a significant volume of acute care, yet they are not counted as “psychiatric hospitals” in many surveys because they are integral parts of a larger medical center. Less than a quarter of all short-term acute care hospitals reported having any inpatient psychiatric beds in 2023. Specialized facilities, such as those run by the Veterans Affairs (VA) system, also exist to serve specific populations and contribute to the overall capacity.
Historical Trends in Facility Counts
The current number of facilities is a direct result of a historical shift in care delivery known as deinstitutionalization. This movement saw the closure of large state psychiatric institutions, which peaked in bed capacity in the mid-1950s. Since 1950, the number of residents in state psychiatric hospitals has fallen by over 92 percent.
Drivers of this change included the development of effective antipsychotic medications, which made community living possible for many patients. Legal shifts emphasizing patient rights and the push toward integrating individuals into community-based care also played a significant role. However, the reduction in state hospital beds—which decreased by over 500,000 since the 1950s—was not fully matched by the creation of adequate community services.
While state hospital capacity declined sharply, other types of facilities saw increases, which partially offset the loss of beds. For example, between 2010 and 2018, general hospital psychiatric unit beds increased by over 25 percent, and private psychiatric hospital patient numbers more than doubled. This redistribution of care shifted the burden from large, long-term state facilities to a combination of short-term acute units and private hospitals.
Measuring Capacity and Bed Availability
Focusing solely on the number of buildings does not adequately reflect the availability of resources for treatment; the more relevant metric is the number of inpatient psychiatric beds per capita. As of 2023, the U.S. had approximately 28.4 inpatient psychiatric beds per 100,000 people. This figure is notably lower than the optimal level of 60 beds per 100,000 population suggested by experts.
This shortage of beds creates significant issues in accessing care, leading to longer emergency department wait times for individuals experiencing a mental health crisis. The limited inpatient capacity often results in a strain on other systems, including the criminal justice system, which increasingly manages individuals with acute mental illnesses. Furthermore, the availability of beds is not uniform across the country, with many counties having no inpatient psychiatric beds at all.
The number of beds in short-term acute care hospitals fell from 11.3 per 100,000 in 2011 to 9.06 per 100,000 in 2023, even as the rate in psychiatric hospitals slightly increased. This trend highlights a decline in psychiatric capacity within general medical settings. The overall shortage of beds means that the existing facilities, regardless of their total count, are often operating at or beyond full capacity, limiting access for those who urgently need stabilization and treatment.