Boarding Crisis: Kids’ Mental Health

Summary

Emergency department boarding times for pediatric mental health patients are increasing, impacting patient care and hospital resources. Several factors contribute to this issue, including a shortage of inpatient psychiatric beds, increased demand for mental health services, and the complexity of cases. Potential solutions involve expanding access to mental healthcare services, improving hospital flow, and implementing stabilization protocols in emergency departments.

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** Main Story**

Okay, let’s talk about something that’s been weighing heavily on my mind – the pediatric mental health crisis. Specifically, the crazy long boarding times we’re seeing in emergency departments (EDs). It’s not just a statistic; it’s impacting kids and the already-stretched healthcare staff.

You see, this isn’t some abstract problem; it has real consequences. What’s causing it, and more importantly, what can we do?

The Problem: Waiting… and Waiting…

So, boarding. It basically means holding patients in the ED after the decision’s been made to admit them, but there’s no bed available. The Joint Commission says boarding shouldn’t exceed four hours. But sometimes it isn’t that simple.

I’ve heard of kids, some of them barely teenagers, stuck in the ED for days, even weeks, waiting for a psychiatric bed. Can you imagine how that feels? Existing symptoms get worse, the risk of self-harm skyrockets, and it’s just plain traumatizing. It’s tough.

Why Is This Happening?

Honestly, it’s a perfect storm of problems.

For one, we’ve got a critical shortage of inpatient psychiatric beds. This stems from funding issues, a lack of mental health professionals (which is an entirely separate problem), and a heartbreaking number of facility closures over the years. It seems like they just don’t care.

Then, bam, the COVID-19 pandemic hit. Lockdowns, social isolation… it wreaked havoc on young people’s mental well-being. The demand for services exploded.

Plus, a lot of these kids have complex cases – co-occurring medical and psychiatric conditions, or needing specialized care. All of this is making placement incredibly difficult. It’s like trying to fit a square peg in a round hole.

The Real Cost: Impact on Young Patients

Extended boarding is just detrimental. The ED is designed for stabilization, not long-term care. It’s loud, there’s no privacy, and access to therapy is limited. These things exacerbate existing issues such as anxiety, depression and other horrible symptoms. It’s doing more harm than good, in many cases.

Not only that, but it delays getting kids the psychiatric treatment they desperately need. Recovery is hindered, and the risk of negative outcomes increases. And I’m not just talking about the kids; families are going through hell, too.

What Can We Do? Potential Solutions

Okay, so what are we to do? It needs to be a multi-pronged effort.

• More beds: We need to invest in new facilities, increase funding, and get more mental health professionals into underserved areas.
• Streamline processes: I am talking about speeding up admissions, improving communication between ED staff and inpatient units, and ensuring timely access to community-based services.
• Stabilization protocols: Implement protocols in EDs, like brief therapy sessions, medication management, and connecting families with support services. I heard Boston Children’s Hospital has seen good results doing this.

Tech to the Rescue? Advancements in Care

Technology can play a role, too. Telemedicine, remote monitoring… they can improve access, especially in rural areas. Digital therapeutics – apps, online platforms – can provide support and tools.

Technology also helps with communication between providers and families. Electronic health records streamline information, and wearable devices can continuously monitor patients. Artificial intelligence? That’s got the potential to improve diagnosis and treatment.

Look, I know it’s a complicated situation. There’s no one-size-fits-all solution. But by investing in resources, streamlining processes, and embracing technology, we can create a better system. A system that gives these kids the timely, appropriate care they deserve, and that gives us peace of mind, knowing we’re doing everything we can.