Dutch mental health care has evolved into an extensive system of hospitaland community-based services, including outpatient clinics, day and home treatment, rehabilitation programs, and sheltered living arrangements. However, 16 million people in the Netherlands still occupy a large number of psychiatric beds: about 1 .6 beds in general mental hospitals and psychiatric departments in general hospitals per 1,000 of the adult and elderly population [ 1 ] . This figure is much higher than the 0.4 beds per 1 ,000 in Spain [2], 0.8 in Denmark [3], or 0.9 in Germany, but comparable with the 1.4 and 1.6 beds in Switzerland [4] and France [5], respectively, and lower than the 2.6 beds in Luxembourg [4]. Although most countries reduced the number of beds for psychiatric care considerably (40 percent to 60 percent) in the 1980s, the absolute number of beds in general mental hospitals in the Netherlands has hardly changed over the last 20 years (21,000-22,000) and has decreased only slightly if population growth is taken into account. However, these administrative national statistics show formal bed capacity for inpatient facilities that may not reflect their ac-
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