The Impact of Reducing Psychiatric Beds on Suicide Rates

Abstract

There has been ongoing debate regarding the impact of reductions in psychiatric beds on suicide rates, and the potential effect of reallocation of acute hospital funding to community-based mental health programs and services. Computer simulation offers significant value in advancing such debate by providing a robust platform for exploring strategic resource allocation scenarios before they are implemented in the real world. We report an application that demonstrates a threshold effect of cuts to psychiatric beds on suicide rates and the role of context specific variations in population, behavioral, and service use dynamics in determining where that threshold lies. Findings have important implications for regional decision-making regarding resource allocation for suicide prevention.

Keywords: psychiatric beds; public mental health; suicide prevention; systems modeling and simulation; threshold effects.

Figure 1

Impact of changes in psychiatric bed availability and community-based mental health service capacity on forecast percentage changes in suicide (Western Sydney, 2018–2028) *(A) Change in the total number of suicides over the period 2018–2028 compared with the baseline scenario (expressed as a percentage of the baseline total) as a function of the number of psychiatric beds per 10⁵ population assuming different levels of non-secondary services capacity (i.e., numbers of community-based practitioners per 10⁵ population). The dashed vertical line indicates the baseline number of psychiatric beds per 10⁵ population. (B) Percentage change in the number of suicides (compared with the baseline total) as a function of secondary and non-secondary services capacity. The cross in the lower right corner indicates the baseline capacity values (27.86 psychiatric beds and 10.55 community-based practitioners per 10⁵ population).