Raising the Bar: Growth of Specialized Hospital Psychiatric Units for Youths With Neurodevelopmental Disabilities

Co-occurring psychiatric conditions and externalizing behaviors are prevalent among youths with neurodevelopmental disabilities (NDDs). For youths with NDDs and serious emotional and behavioral challenges, specialized inpatient psychiatric units are a critical part of the care continuum. Since 2011, the number of these units, their geographic distribution, and the diversity of their host institutions have expanded, and a coalescence has formed around a care model. This study aimed to examine these specialized units and describe their key features.

A 41-item survey was developed and distributed in 2023 to organizations that have an inpatient psychiatric unit dedicated to youths with NDDs.

Twenty units were identified, with at least one in every major U.S. geographic region; the directors of 13 units responded to the survey. These units served primarily male (70%), non-Hispanic (89%), White (62%) patients ages 13-18 years (57%) with autism spectrum disorder (88%). The average length of stay was 41.3 days (median=34.2 days). The average unit size was 15 beds. Most units were in psychiatric hospitals (62%) and were part of nonprofit organizations (77%). The units deployed multidisciplinary teams, with an average of seven disciplines represented. All units employed psychologists or board-certified behavior analysts.

The number of specialized inpatient psychiatric units for youths with NDDs in the United States has more than doubled since 2011, and the geographic distribution of these units has widened. Nationwide, units use similar treatment models to provide a distinct form of targeted patient care to meet the needs of this growing and unique population.