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Pediatric Mental Health Boarding: 2017 to 2023.
Kathleen D Snow1, Jonathan M Mansbach1, Christopher Cortina1
1Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts.
Pediatrics
|February 12, 2025
Summary
Pediatric mental health boarding in children's hospitals is increasing, with longer stays for complex cases. This highlights a need for improved access to psychiatric care for children.
Area of Science:
- Pediatric healthcare
- Mental health services
- Health services research
Background:
- Pediatric mental health (MH) boarding is prevalent in US children's hospitals.
- Patients board while awaiting transfer to psychiatric facilities.
Purpose of the Study:
- To describe trends in pediatric MH boarding encounters.
- To identify factors associated with prolonged boarding length of stay.
Main Methods:
- Retrospective cross-sectional study.
- Analysis of 100,784 boarding encounters from 2017-2023 at 40 children's hospitals.
- Mixed effects logistic regression used to identify risk factors for prolonged boarding (≥9 days).
Main Results:
- Median length of stay increased from 3 to 4 days.
- Factors associated with prolonged boarding included older age, government insurance, increased medical complexity, specific psychiatric disorders, season, and discharge to home.
- Significant variation in boarding practices observed among hospitals.
Conclusions:
- Pediatric MH boarding remains common, with increased volume and length of stay post-COVID-19.
- Patients with medical and/or psychiatric complexity face prolonged boarding.
- Improved access to care is needed for these vulnerable children.
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