Does deinstitutionalization increase suicide?

Jangho Yoon*, Tim A. Bruckner

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

32 Scopus citations


Objectives. (1) To test whether public psychiatric bed reduction may increase suicide rates; (2) to investigate whether the supply of private hospital psychiatric bedsseparately for not-for-profit and for-profitcan substitute for public bed reduction without increasing suicides; and (3) to examine whether the level of community mental health resources moderates the relationship between public bed reduction and suicide rates. Methods. We examined state-level variation in suicide rates in relation to psychiatric beds and community mental health spending in the United States for the years 1982 1998.We categorize psychiatric beds separately for public, not-for-profit, and for-profit hospitals. Principal Findings. Reduced public psychiatric bed supply was found to increase suicide rates. We found no evidence that not-for-profit or for-profit bed supply compensates for public bed reductions. However, greater community mental health spending buffers the adverse effect of public bed reductions on suicide. We estimate that in 2008, an additional decline in public psychiatric hospital beds would raise suicide rates for almost all states. Conclusions. Downsizing of public inpatient mental health services may increase suicide rates. Nevertheless, an increase in community mental health funding may be promising.

Original languageEnglish
Pages (from-to)1385-1405
Number of pages21
JournalHealth Services Research
Issue number4
StatePublished - Aug 2009
Externally publishedYes


  • Community mental health
  • Deinstitutionalization
  • Privatization
  • Psychiatric beds
  • Suicide


Dive into the research topics of 'Does deinstitutionalization increase suicide?'. Together they form a unique fingerprint.

Cite this