Psychiatric Boarding in the Pediatric Inpatient Medical Setting: A Retrospective Analysis

Gallagher, Katherine A.; Bujoreanu, I. Simona; Cheung, Priscilla; Choi, Christine; Golden, S.K.; Brodziak, Kerry; Andrade, Gabriela; Ibeziako, Patricia

doi:10.1542/hpeds.2017-0005

Cited by 44 publications

(38 citation statements)

References 17 publications

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“…[6][7][8] As a result, ED mental health visits are associated with long wait times, which are due in part to psychiatric "boarding" (in which a patient waits in the ED for an inpatient bed). 9,10 Pediatric ED visits have steadily increased over the last several decades. [11][12][13][14][15][16] The most recent estimates suggest that 5% to 7% of all pediatric ED visits in the United States are related to mental health and/or substance abuse.…”

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confidence: 99%

Trends in Psychiatric Emergency Department Visits Among Youth and Young Adults in the US

et al. 2019

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BACKGROUND: Visits to the emergency department (ED) for psychiatric purposes are an indicator of chronic and acute unmet mental health needs. In the current study, we examined if psychiatric ED visits among individuals 6 to 24 years of age are increasing nationwide. METHODS: ED data came from the 2011-2015 National Hospital Ambulatory Medical Care Survey, a national survey of ED visits across the United States. Psychiatric ED visits were identified by using the International Classification of Diseases, Ninth Revision and reason-forvisit codes. Survey-weighted logistic regression analyses were employed to examine trends in as well as correlates of psychiatric ED visits. Data from the US Census Bureau were used to examine population rates. RESULTS: Between 2011 and 2015, there was a 28% overall increase (from 31.3 to 40.2) in psychiatric ED visits per 1000 youth in the United States. The largest increases in psychiatric ED visits per 1000 US youth were observed among adolescents (54%) and African American (53%) and Hispanic patients (91%). A large increase in suicide-related visits (by 2.5-fold) was observed among adolescents (4.6-11.7 visits per 1000 US youth). Although psychiatric ED visits were long (51% were $3 hours in length), few (16%) patients were seen by a mental health professional during their visit. CONCLUSIONS: Visits to the ED for psychiatric purposes among youth are rising across the United States. Psychiatric expertise and effective mental health treatment options, particular those used to address the rising suicide epidemic among adolescents, are needed in the ED.

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Trends in Psychiatric Emergency Department Visits Among Youth and Young Adults in the US

et al. 2019

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“…TJC defines "boarding" as holding a patient in a temporary location in the hospital while awaiting placement that is not yet available. 54 Boarding is also the appropriate term for children admitted medically with co-occurring psychiatric and medical needs who, once medically stable, are maintained inpatient medically while awaiting placement in a psychiatric inpatient unit. 54 Boarding has become more commonplace in recent years as ED visits for child psychiatric emergencies have been increasing-nearly doubling since 2001 55 while the availability of pediatric inpatient psychiatric beds nationally has been decreasing.…”

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confidence: 99%

Pediatric Consultation-Liaison Psychiatry: An Update and Review

2020

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Background: In recent years, there has been an increasing burden of child and adolescent mental illness recognized in the United States, and the need for pediatric mental health care is growing. Pediatric consultation-liaison (C-L) psychiatrists are increasingly playing a role in the management of medical and psychiatric disease for pediatric patients. The field is a fast-moving one, with understanding of new neuropsychiatric disease entities; reformulation of prior disease entities; and new interdisciplinary treatments and models of care. Methods: In this study, we aim to review recent advances in the field of pediatric C-L psychiatry, including new diagnostic entities, updated management of frequently encountered clinical presentations, and developments in systems of care. Conclusion: The advances in pediatric C-L psychiatry are broad and serve to promote more streamlined, evidence-based care for the vulnerable population of psychiatrically ill pediatric medical patients. More work remains to determine the most effective interventions for the wide array of presentations seen by pediatric C-L psychiatrists.

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“…Though Deepika Shaligram offered a thoughtful review of this text for the journal in 2015, many people still do not know about this resource, and those who have encountered often sing it praises. 4 Hence, as many of our systems of care and emergency departments struggle to optimally meet the needs of children in crisis, 5 we asked Kelly Ochoa to provide an updated perspective on this book. when the film was shot, Eighth Grade is irreverent and feels essential.…”

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Book forum

Merritt

Williamson

2019

Journal of the American Academy of Child & Adolescent Psych

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Psychiatric Boarding in the Pediatric Inpatient Medical Setting: A Retrospective Analysis

Abstract: Psychiatric boarding presents many challenges for families, providers, and the health care system, and PBs have complex psychiatric histories and needs. However, boarding may offer a valuable opportunity for psychiatric intervention and stabilization among psychiatrically vulnerable youth.

Cited by 44 publications

References 17 publications

Trends in Psychiatric Emergency Department Visits Among Youth and Young Adults in the US

Trends in Psychiatric Emergency Department Visits Among Youth and Young Adults in the US

Pediatric Consultation-Liaison Psychiatry: An Update and Review

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