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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.<\/jats:p>","DOI":"10.1007\/s00787-025-02902-7","type":"journal-article","created":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T04:57:00Z","timestamp":1761541020000},"page":"641-648","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["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?"],"prefix":"10.1007","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6070-4323","authenticated-orcid":false,"given":"Joerg M.","family":"Fegert","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9530-6285","authenticated-orcid":false,"given":"Isabel","family":"Boege","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5342-1449","authenticated-orcid":false,"given":"Dario","family":"Calderoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0454-1579","authenticated-orcid":false,"given":"Diane","family":"Purper-Ouakil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1632-2587","authenticated-orcid":false,"given":"Emily","family":"Sitarski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8093-7383","authenticated-orcid":false,"given":"Benedetto","family":"Vitiello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,27]]},"reference":[{"issue":"9","key":"2902_CR1","doi-asserted-by":"publisher","first-page":"731","DOI":"10.1016\/S2215-0366(24)00163-9","volume":"11","author":"PD McGorry","year":"2024","unstructured":"McGorry PD, Mei C, Dalal N, Alvarez-Jimenez M et al (2024) The lancet psychiatry commission on youth mental health. 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Travel grants, honoraria, sponsorship for conferences and medical educational purposes from APK, Adenauer- und Ebert Foundation, Deutschlandfunk, DFG, DJI, DKSB, Infectopharm, med update, UNICEF, professional associations, universities and federal and state ministries. Consultant for APK e.V., University Hospital Saarland\/State Chancellery, federal and state ministries, Servier. No industry-sponsored lecture series, no shareholdings, no participation in pharmaceutical companies.DPO (last five years): Research from EU, National Funds (PHRC-N, ANR). Travel grantsand speakers honoraria (Medice, Teva). Participation in speakers\u2019 board (Medice), travel grants without honoraria (HAC Pharma, Biocodex).BV (last five years): consultant honoraria from Medice, Angelini\/Ethos, Menarini, Alkermes Pharmaceuticals, and the U.S. National Institute of Mental Health, and Swiss National Science Foundation; research grants from the CRT Foundation, Italian Autism Foundation, and Italian Ministry of Universities and Research (MUR).ES, IB and DC have no conflicts of interest to declare.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}