Private Psychiatric & Addiction Hospital
The industry — Psychiatric and substance use hospitals
Base industry report for 6222 →- Establishments · CanadaA
- 74
- Under 10 employeesA
- 18%
Of 74 Canadian establishments with employees, 18% have fewer than ten — an industry where large establishments carry real weight.
Entry signal — what decides who wins here
Structure decidesThe binding constraint is not executional. Being better than the incumbent does not, by itself, get you in — this one is cleared with capital, an asset, or a permission.
Raise or borrow the entry ticket, or buy an operator who has already paid it. The barrier is money rather than permission, so it yields to a balance sheet — and an acquisition is usually cheaper than a start.
Measured, not forecast: the share of US establishments opening in one year that were still active later. It counts good operators and bad ones together, which is exactly why it is the honest answer to “what are the odds”. It is for the whole sector rather than this market, and the ten-year figure comes from an older cohort because no younger one has reached ten years.
This is not a probability of success, and it is not a verdict on you. No survival probability is published per market, and inventing one would be worse than saying so. What the bar reads is how much of the outcome sits inside an operator's control: green means the hurdles are ones a better operator clears, red means the binding constraint is capital, an asset or a permission rather than execution. Someone arriving with an advantage this screen did not assume can win a market shown in red.
Companies named in this market · 4
The binding constraint — entry cost + regulatory drag
Demand is not in question, and where private entry is allowed the business exists at scale. Acadia Healthcare, a listed US pure-play in behavioural health, reported 2025 revenue of $3,312.8M, up 5.0%, across 277 facilities and over 12,500 beds, and added 1,089 licensed beds in the year [A]. The same release is a warning about the economics even where the door is open: adjusted EBITDA fell to $608.9M from $709.0M, capital expenditure was $571.8M, and the company booked a $996.2M goodwill impairment [A]. Beds are expensive to add and their return is set by payers and by regulators' scrutiny of admissions. In Canada the door is mostly closed, and that is the cut. An establishment in this code must be licensed as a hospital, and hospital status, global budgets and physician billing for psychiatric in-patient care sit inside provincial health systems. The count shows it: of 74 establishments, 20 employ 500 or more and another 14 employ 100 to 499 — the public mental-health centres — and the small remainder are units and affiliates, not start-ups. If capital were no object an entrant would still have no licence to apply for and no payer to bill. What a private operator can open in Canada is a residential treatment centre that is not a hospital, funded by private pay, employer benefits and some public contracts; that sits in 6232 and should be screened there. The hospital software sold to this industry is screened separately at 6221.
Psychiatric hospitals are designated under provincial mental-health legislation and funded through provincial or regional health authorities, and patients are referred and admitted within that system. The competitive geography is the province and its health regions; a national total of beds or spending is not addressable by any single operator.
Who you would be competing with
The operators already at scale here, and whoever is buying these businesses. In most of these industries the competition an entrant meets is local, so this is who sets the terms rather than a list of everyone in the trade.
Financials & market size — sourced
Figures that came from a filing, a results release or reputable reporting, each carrying its evidence tier.
Market size, derived
Built from the competitor set upward rather than quoted from a forecast. Published TAMs in these categories are frequently reverse-engineered from each other, so any published figure is checked against the vendor arithmetic rather than trusted on its own.
Disclosed revenue from 2 of 4 named vendors. The market is at least this large.
No vendor has both a disclosed revenue and a published share.
Only a revenue floor is known — the true market is larger by whatever the undisclosed vendors earn.
Competitor set · 4 named · 2 disclose revenue
| Name | Revenue | Share | Note |
|---|---|---|---|
| Acadia HealthcareNASDAQ: ACHCA | $3.3B | — | FY2025 revenue, from the Q4/FY2025 results release filed as exhibit 99 to an 8-K |
| Universal Health ServicesNYSE: UHSA | $17.4B | — | FY2025 consolidated net revenues, from the 10-K filed 25 February 2026; the company states that behavioural health care facilities together with its commercial health insurer accounted for approximately 43% of that total |
| The provincial health authoritiesB | not disclosed | — | Own, designate and fund Canada's psychiatric beds; 20 of 74 establishments in this code employ 500 or more. No Canadian psychiatric-hospital revenue or budget figure was opened for this record |
| Homewood Health / EHN CanadaC | not disclosed | — | The nearest things to private Canadian operators in and around this code; privately held, nothing disclosed, and not researched for this record |
Evidence
Evidence. Acadia Healthcare's figures were read from its Q4/FY2025 results release as filed on SEC EDGAR (exhibit 99 to its 8-K) [A]. Acadia's network includes residential and outpatient facilities as well as hospitals, so it is a scale anchor for private behavioural care generally, not a clean measure of NAICS 6222. The establishment count is Statistics Canada, December 2023 [A]; no US County Business Patterns figures joined for this code. Universal Health Services' behavioural facility counts, its United Kingdom behavioural revenue of approximately $1.001 billion for 2025, its bed, occupancy, admission and length-of-stay statistics and its consolidated net revenues were read from its Form 10-K for the year ended 31 December 2025, filed on EDGAR on 25 February 2026 [A]; the 43% figure is UHS's own statement and bundles its commercial health insurer with the behavioural facilities, so no clean segment revenue is claimed from it. UHS's United Kingdom operations are cited because they show a private behavioural hospital business running inside a single-payer system, not because Britain's rules transfer to Canada. What was not sourced: any Canadian financial figure. The revenues of Canada's public psychiatric hospitals and of the private operators (Homewood, EHN Canada) were not opened, and the statement that there is no route to a new private psychiatric hospital licence is a reading of how provincial systems work, not a citation of each province's statute. The cut factor is analyst judgment.
Where the industry talks
The associations, forums and events where people in this trade actually talk shop — where to listen before entering, and where the first customers are found. Each link was opened on the date shown.
Association of psychiatric and addiction hospital operators; policy work on the IMD exclusion, parity and ligature risk, plus an annual meeting.
Business association for addiction treatment operators; publishes insurance reimbursement benchmarking reports.
Site says it represents about 4,700 psychiatrists and 900 residents; 76th annual conference Montreal, November 2026.
Physician society in addiction medicine; 2026 scientific conference and annual meeting in Calgary, November 2026.
Page states it represents over 150 addictions and mental health organizations in Ontario; runs an annual conference and communities of practice.
Page states more than 3,200 member organizations; runs NatCon, the sector's main US conference.
Canada has almost no private operators, so the live communities are clinical societies and provincial sector associations; the operator-side bodies are American.