In the absence of that option, emergency rooms have taken over. A recent study of 88 pediatric hospitals across the country found that 87 of them regularly admit children and adolescents overnight to the emergency room. On average, any hospital saw four admissions per day, with an average stay of 48 hours.
“There is a pediatric mental health boarding school 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 the nation’s 4,000 emergency departments each night.
“We have a national crisis,” said Dr. Leyenaar.
This trend flies in the face of recommended best practices set forth by the Joint Commission, a nonprofit organization that helps set national health care policy. According to the rule, adolescents who go to the emergency room for mental health reasons should not stay there more than four hours, since a prolonged stay can jeopardize the safety of the patient, delay treatment and divert resources from other emergencies.
Yet in 2021, the average teen interned in the Boston Children’s Hospital ER spent nine days waiting for an inpatient bed, compared to three and a half days in 2019; at Children’s Hospital Colorado in Aurora in 2021, the average wait was eight days, and at Connecticut Children’s Medical Center in Hartford, it was six.
Emergency department admissions have also increased in small rural hospitals, with “no pediatric or mental health services.” specialists,” said Dr. Christian Pulcini, a pediatrician in Vermont who has study the trend in the state. “There is a clear conclusion,” she recently told the Vermont legislature. “The emergency department is not the appropriate setting for children to receive comprehensive acute mental health services.”
