Actual psychiatric bed utilization in 16 metropolitan areas was compared with projected bed needs in those areas derived from seven common methods of assessing the need for inpatient psychiatric services. Six methods significantly underpredicted actual use, and one significantly overpredicted actual use. Methods that relied on multiple sources, including expert opinion, historical use, epidemiologic data, and social indicators, predicted need more accurately than those that relied exclusively on expert opinion or historical use. The author also found that utilization rates of acute beds in general and specialty hospitals kept pace with licensed bed rates at or below 45 to 50 beds per 100,000 population but remained steady if the number of licensed beds went higher. The author recommends reliance on local indicators to plan inpatient services.