# About differences in the availability of child and adolescent psychiatric hospital beds across Europe and possible implications for mental health care. Are more or less hospital beds the solution to the youth mental health crisis? Based on a debate at the 21st International Congress of the European Society for Child and Adolescent Psychiatry, Strasbourg, June 30, 2025

## TL;DR

This paper explores whether increasing child and adolescent psychiatric hospital beds in Europe can solve the youth mental health crisis.

## Contribution

The paper highlights the lack of correlation between hospital bed availability and improved mental health outcomes, advocating for innovative care models.

## Key findings

- International comparisons show significant variation in hospital bed availability without corresponding mental health improvements.
- Outpatient and home-based interventions can reduce hospital dependence without compromising treatment efficacy.
- Digital mental health support and community-based models offer potential solutions to expand access and conserve resources.

## Abstract

A number of indicators point to a decline in youth mental health globally over the past 15 years. Access to medical treatment and assistance is becoming increasingly difficult as the social divide is widening due to an imbalance between supply and demand. Hospitalization remains a critical yet costly component of child and adolescent mental health care, reserved for the most severe cases. While necessary in some situations, inpatient treatment carries substantial drawbacks, including family separation and social disruption. This paper discusses if increasing hospital beds across Europe can be the solution to the youth mental health crises by examining differences in the availability of child and adolescent psychiatric hospital beds across Europe. International comparisons reveal striking heterogeneity in hospital beds availability, which does not correlate with improved mental health and behavioral outcomes in young people at the population level. Furthermore, the data does not suggest that this heterogeneity reflects the need to address different levels of psychopathology. Besides the limitations of the currently available data, evidence suggest that effective outpatient and home-based interventions can reduce hospital dependence without compromising treatment efficacy. The COVID-19 pandemic highlighted both the vulnerability of traditional services and the growing role of digital mental health support, which adolescents increasingly access via online platforms. Emerging stepped-care and community-based models, including lay-provider interventions, demonstrate potential to expand reach while conserving specialized resources. Given scarce capacity, European-wide recommendations are needed to ensure equitable access to acute care, while integrating innovative, digitally supported, low-threshold services into youth mental health systems.