Challenges With Long-Term Care Placement in Pediatric Psychiatry During COVID-19: A Case Series From Inpatient Unit

A large number of children and youth have been affected worldwide during the coronavirus disease 2019 (COVID-19) pandemic. Apart from the obvious medical and financial impacts of the COVID-19 pandemic, there has been an immense amount of psychosocial impact specifically on children and adolescents ranging from parents losing their jobs leading to financial hardships to school closure leading to not having significant interaction with their peers and having to spend more time at home which often leads to psychosocial conflicts. According to the literature review, in recent times, there has been worsening of mental health illnesses, increased suicide attempts, and severity of suicide attempts which has led to more visits to the hospitals and clinics with psychiatric concerns. There has been a pattern of increasing patient acuity in inpatient psychiatric units, more specifically in the pediatric units. The average length of stay for inpatient units has been increasing in the pediatric psychiatric units and an unfortunate downside of which has been noted to be increased lag time for placements in foster care systems or residential treatment centers in recent times. Here, we present cases of three teenagers who faced significant challenges in obtaining placement to foster care systems or residential treatment centers in the context of longer wait times experienced for intensive-out-of-home treatment services during the COVID-19 pandemic and discuss potential solutions to this issue.