CONTEXT: The growing prevalence of pediatric mental and behavioral health disorders, coupled with scarce psychiatric resources, has resulted in a substantial increase in the number of youth waiting in emergency departments (EDs) and medical units for inpatient psychiatric care. OBJECTIVE: To characterize the prevalence of pediatric mental health boarding and identify associated patient and hospital factors. DATA SOURCES: Medline and PsycINFO. STUDY SELECTION: All studies describing frequencies, durations, processes, outcomes, and/or risk factors associated with pediatric mental health boarding in youth #21 years of age. DATA EXTRACTION: Publications meeting inclusion criteria were charted by 2 authors and critically appraised for quality. RESULTS: Eleven studies met inclusion criteria; 10 were retrospective cohort studies and 9 were conducted at single centers. All of the single-center studies were conducted at children's hospitals or pediatric EDs in urban or suburban settings. Study sample sizes ranged from 27 to 44 328. Among youth requiring inpatient psychiatric care, 23% to 58% experienced boarding and 26% to 49% boarded on inpatient medical units. Average boarding durations ranged from 5 to 41 hours in EDs and 2 to 3 days in inpatient units. Risk factors included younger age, suicidal or homicidal ideation, and presentation to a hospital during nonsummer months. Care processes and outcomes were infrequently described. When reported, provision of psychosocial services varied widely. LIMITATIONS: Boarding definitions were heterogeneous, study sample sizes were small, and rural regions and general hospitals were underrepresented. CONCLUSIONS: Pediatric mental health boarding is prevalent and understudied. Additional research representing diverse hospital types and geographic regions is needed to inform clinical interventions and health care policy.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.