Boarding Common for Pediatric Mental Health Emergency Department Visits

Differences in boarding seen by race, ethnicity, and insurance type

By Lori Solomon HealthDay Reporter

FRIDAY, June 6, 2025 (HealthDay News) — One-third of pediatric mental health emergency department visits resulting in admission or transfer exceeded 12 hours, according to a study published in the August issue of the Journal of the American College of Emergency Physicians Open.

Jennifer A. Hoffmann, M.D., from the Northwestern University Feinberg School of Medicine in Chicago, and colleagues assessed characteristics associated with boarding among pediatric mental health emergency department visits using data from the National Hospital Ambulatory Medical Care Survey (2018 to 2022). The analysis included 5.9 million pediatric mental health emergency department visits.

The researchers found that 25.2 percent of visits resulted in admission or transfer, and of those, 32.1 percent had length ≥12 hours. Odds of boarding were lower for visits by 10- to 14-year-olds (adjusted odds ratio [aOR], 0.19) than for 15- to 17-year-olds, for visits by patients identifying as non-Hispanic other (aOR, 0.06) versus non-Hispanic White patients, for visits with private insurance (aOR, 0.31) versus public insurance, and for visits on weekends (aOR, 0.27) versus weekdays.

“Our study underscores significant issues with access to mental health care for children and adolescents, who often face prolonged emergency department stays because a psychiatric bed is not available,” Hoffmann said in a statement. “As the youth mental health crisis continues, we have been seeing more severe psychiatric conditions in the emergency department. Most of these kids seek emergency care at adult hospitals, which often have more limited pediatric resources compared to children’s hospitals and might not be prepared to provide the necessary supports.”