In the absence of that option, emergency services have taken over the looseness. A recent study of 88 pediatric hospitals nationwide found that 87 regularly receive children and adolescents overnight in the emergency room On average, any hospital receives four people a day, with an average stay of 48 hours.
“There is a pediatric mental health pandemic,” said Dr. JoAnna K. Leyenaar, a pediatrician at Dartmouth-Hitchcock Medical Center and lead author of the study. In an interview, she extrapolated from her research and other data to estimate that at least 1,000 young people, and perhaps as many as 5,000, board every night in the country’s 4,000 emergency departments.
“We have a national crisis,” Dr. Leyenaar said.
This trend is far from the recommended best practices established by the Joint Commission, a non-profit organization that helps determine national health policy. According to the standard, adolescents who come to the emergency room for mental health reasons should not stay there for more than four hours, as extended stays can jeopardize patient safety, delay treatment, and divert resources from other emergencies.
Yet in 2021, the average adolescent who was placed in an emergency room at Boston Children’s Hospital spent nine days waiting for a hospital bed, compared to three and a half days in 2019; at Colorado Children’s Hospital in Aurora 2021 the average wait was eight days, and at Connecticut Children’s Medical Center in Hartford six.
Even in small, rural hospitals, the number of boardings in emergency services has increased, “without pediatric or mental health specialists, ”said Dr. Christian Pulcini, a Vermont pediatrician who studied the trend in the state. “There is one clear conclusion,” he told the Vermont legislature recently. “ED is not an appropriate environment for children to receive comprehensive, acute mental health services.”