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Behavioral Emergency Response Team Alert Disparities in a Single-Site Pediatric Hospital

Rachel Peterson1,2, Edward Kim3, Angela Amaniampong4

  • 1Department of Pediatrics, Division of Hospital Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio.

Hospital Pediatrics
|March 23, 2025
PubMed

Insights

Black patients experienced higher rates of Behavioral Emergency Response Team (BERT) alerts in a pediatric hospital. Mental health diagnoses and government insurance were also linked to increased BERT alerts and physical restraint use.

Area of Science:

  • Pediatric hospital medicine
  • Behavioral emergency response systems
  • Health equity and disparities

Background:

  • Behavioral Emergency Response Teams (BERT) manage psychiatric emergencies and conflicts.
  • BERT alert utilization in pediatric inpatient settings is not well-documented.
  • This study investigates racial disparities in BERT alert activation.

Purpose of the Study:

  • To identify racial differences in BERT alert occurrences among pediatric inpatients.
  • To analyze factors associated with BERT alert activation and physical restraint use.

Main Methods:

  • Retrospective cross-sectional review of inpatient BERT alerts from 2018-2020.
  • Logistic regression analysis examined the association between race and BERT alerts.
  • Adjusted for age, gender, ethnicity, payor, and mental health diagnosis (MHD).

Main Results:

  • Black patients had significantly higher odds of receiving BERT alerts (aOR 2.1).
  • Admissions with private insurance had lower odds of BERT alerts (aOR 0.4).
  • Mental health diagnoses (MHD) were strongly associated with higher BERT alert and physical restraint use.

Conclusions:

  • Black race, government insurance, and MHD were disproportionately represented in BERT alerts.
  • MHD and BERT alerts correlate with increased physical restraint utilization.
  • Findings highlight potential racial and socioeconomic disparities in behavioral emergency response.
Abstract

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