This study aimed to estimate the spatial accessibility of inpatient mental health services in Kerala, India. We also aimed to calculate bed-to-population ratios for these services for each district in the state.

We used a Geospatial Information System (GIS)-based travel time isochrone analysis to estimate potential spatial accessibility.

Kerala, India.

A list of all mental health facilities licensed to admit patients was obtained from data published by the Kerala State Mental Health Authority in 2025. The facilities were geocoded and mapped. Population data were also obtained using satellite-based estimates from 2020 at a resolution of 100 m. Information on Road Networks was obtained using OpenStreetMap through the OpenRouteService plugin in 2025.

We calculated the proportion of people who could access facilities within 15 min, 30 min and 45 min. We also calculated beds per population for each of the 14 districts.

Kerala has an average of 21 mental health beds per 100 000 people, ranging from 0.75 in Kasargod to 68 in Idukki. In terms of bed-to-population ratios, one district was ideal, three met the basic requirements, two experienced slight shortages, four faced moderate shortages and four encountered severe shortages. Across the state, 67.95% of the population could access psychiatric services within 15 min, increasing to 96.85% within 45 min.

GIS-based isochrone analysis indicated that 96.85% of the population could reach a facility by car within 45 min. Bed-to-population ratios varied substantially between districts.