Table 1. Characteristics of Hospitals and Hospital Resources to Support Youths Experiencing Mental Health Boarding.
| Hospital characteristics | No. (%) (N = 85) |
|---|---|
| Hospital type | |
| Freestanding children’s hospital | 38 (44.7) |
| Children’s hospital with larger institution | 35 (41.2) |
| General community hospital | 12 (14.1) |
| No. of general pediatric bedsa | |
| 1-50 | 29 (34.1) |
| 51-100 | 26 (30.6) |
| >100 | 27 (31.8) |
| Licensed pediatric psychiatric beds | 31 (36.5) |
| Hospital location | |
| Urban | 55 (64.7) |
| Suburban | 27 (31.8) |
| Rural | 3 (3.53) |
| Hospital geographic region | |
| Northeast | 24 (28.2) |
| Midwest | 21 (24.7) |
| West | 19 (22.4) |
| South | 21 (24.7) |
| Mental health boarding location | |
| Emergency department | 68 (80.0) |
| Inpatient or observation unit | 73 (85.9) |
| Other | 4 (4.7) |
| Attending physician for boarding youthsb | |
| Emergency department physician | 52 (61.2) |
| Pediatric hospitalist | 72 (84.7) |
| Other | 8 (9.4) |
| Daily No. of youths experiencing mental health boarding, median (IQR)c | 4 (3-7) |
| Emergency department | 3 (2-5) [n = 64] |
| Inpatient or observation unit | 2 (1-4) [n = 70] |
| Other location | 0 (0-2) [n = 3] |
| Duration of mental health boarding per patient, median (IQR), hd | 48 (24-72) |
| Youths boarding >24 h, median (IQR), %e | 75 (50-90) |
| Hospital resources to support youth boarding | |
| Boarding occurs in space designated for mental health care | 32 (37.6) |
| Electronic health record order setb,f | 19 (24.1) |
| Clinical practice guideline or care pathwayb,f | 8 (10.1) |
| Written policy on location of boardingb,f | 10 (12.7) |
| One-on-one safety observationg | 71 (98.6) |
| Psychiatric medication initiation or changesg | 10 (13.9) |
| Psychotherapy by mental health professionalg | 13 (18.1) |
| Behavioral management plan written by mental health professionalg | 26 (36.1) |
| Changes during COVID-19 pandemich | |
| Increased No. of youths boarding | 65 (84.4) |
| Increased duration of boarding | 58 (75.3) |
a
Missing data for 3 hospitals.
b
Missing data for 6 hospitals.
c
Missing data for 4 hospitals.
d
Missing data for 7 hospitals.
e
Missing data for 12 hospitals.
f
Survey response options included “yes,” “no,” and “unsure”; data indicate the No. (%) who reported “yes” to these questions.
g
Responses indicate resource availability on inpatient or observation units; respondents were asked to rate the frequency with which mental health services were provided during the boarding period on a 5-point Likert scale (never, seldom, sometimes, often, always, or unknown); the top 2 response options were combined to indicate routine service availability (there were no “unknown” responses). Missing data for 1 hospital.
h
Missing data for 8 hospitals.