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Pediatric mental health boarding is common, affecting up to 58% of youth needing psychiatric care. More research is needed to address this growing issue in emergency departments (EDs) and hospitals.

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Area of Science:

  • Pediatric mental health
  • Health services research
  • Child and adolescent psychiatry

Background:

  • Increasing prevalence of pediatric mental and behavioral health disorders.
  • Limited psychiatric resources leading to long waits for inpatient care.
  • Youth often experience extended stays in emergency departments (EDs) and medical units awaiting psychiatric placement.

Purpose of the Study:

  • To determine the prevalence of pediatric mental health boarding.
  • To identify patient and hospital factors associated with boarding.
  • To characterize the duration and outcomes of pediatric mental health boarding.

Main Methods:

  • Systematic literature search of Medline and PsycINFO databases.
  • Inclusion of studies on pediatric mental health boarding in youth up to 21 years of age.
  • Data extraction and quality appraisal by two independent authors.

Main Results:

  • Eleven studies met inclusion criteria, mostly retrospective cohort studies from single-center children's hospitals.
  • Prevalence of boarding ranged from 23% to 58% for inpatient psychiatric care and 26% to 49% on medical units.
  • Average boarding durations were 5-41 hours in EDs and 2-3 days on inpatient units; risk factors included younger age and suicidal ideation.

Conclusions:

  • Pediatric mental health boarding is a prevalent issue that is currently understudied.
  • Heterogeneous boarding definitions and underrepresentation of rural/general hospitals limit current understanding.
  • Further research across diverse settings is crucial for developing effective interventions and policies.