Prevalence of Pediatric Mental Health Boarding in Acute Care Settings

Boarding for pediatric mental health conditions while waiting for acute psychiatric care has become increasingly common, according to a recent study published in the journal Pediatrics. The study highlights substantial variations in boarding practices across different hospital sites.

Researchers from Boston Children's Hospital conducted a comprehensive retrospective analysis of pediatric mental health boarding cases at 40 tertiary children's hospitals over a six-year period, examining data from January 1, 2017, to December 31, 2023. This study focused on children aged 3 to 18 years who presented with primary psychiatric diagnoses.

In total, the analysis involved 100,784 boarding encounters across the 40 hospitals. Findings revealed a noticeable increase in the median length of stay for these encounters, rising from three days to four days. Alarmingly, 0.3% of the children experienced boarding periods exceeding 100 days. The study also identified significant differences in boarding practices based on the specific hospital.

Factors contributing to extended boarding times included the age of the patients, the type of government insurance they had, the complexity of their medical conditions, the specific psychiatric disorders presented, the season in which they sought care, and whether they were discharged to their homes.

The authors of the study emphasize that pediatric mental health boarding is a frequent occurrence in acute care settings, and many patients are now facing prolonged waits for psychiatric services, particularly those with both medical and psychiatric complexities.

For further details, the study is accessible in the journal Pediatrics.