Reducing Pediatric Mental Health Boarding and Increasing Acute Care Access

Area of Science:

• Pediatric mental health
• Healthcare access
• Hospital administration

Background:

• Rising pediatric mental health boarding presents a crisis in the US.
• Youth often wait in emergency departments or medical units for psychiatric placement.
• This highlights a critical need for improved acute psychiatric services.

Purpose of the Study:

• To assess the impact of interventions on reducing pediatric mental health boarding.
• To evaluate improvements in access to acute psychiatric care during a national crisis.
• To analyze outcomes at a tertiary pediatric hospital.

Main Methods:

• Interventions involved expanding inpatient psychiatric beds and hiring staff for crisis stabilization.
• Retrospective review of patients (≤17 years) with mental health emergencies (Oct-Dec 2021 vs. Oct-Dec 2022).
• Primary outcome: mean length of boarding (LOB); Secondary outcome: mean length of stay (LOS) in acute psychiatry units.

Main Results:

• Mean LOB decreased by 53% (4.3 vs. 9.1 days) one year post-intervention.
• Mean LOS in acute psychiatry programs reduced by 27% (20.0 vs. 14.6 days).
• Access to acute psychiatry programs increased (54.2% vs. 41.9%). Youth with aggressive behaviors or prior admissions experienced longer boarding times.

Conclusions:

• Comprehensive interventions significantly decreased pediatric mental health boarding and improved access to care.
• Challenges persist in placement for youth with aggressive behaviors.
• Pediatric hospitals should invest in acute psychiatric resources to address boarding.