Pediatric mental health bed capacity remains static despite increased demand

U.S. pediatric inpatient psychiatric bed capacity did not change 2017 – 2020, despite increases in pediatric mental health emergency visits, according to a study published in JAMA Pediatrics. Researchers also found substantial geographic variation in inpatient psychiatric bed capacity per 100,000 children, ranging from zero in Alaska to 75 in Arkansas. Over 90 percent of pediatric inpatient beds are in urban centers, raising concerns for youth living in rural areas.

Access to psychiatric inpatient care for youth is insufficient to meet the growing demand, forcing patients to wait for hours or even days in emergency departments or on medical units until a psychiatric bed becomes available. It is also critical to ensure that access is equitably distributed across the country, as well as available in rural areas where we found a serious shortage of psychiatric beds for youth. Every child deserves access to psychiatric care. The lack of psychiatric beds for children in some areas places a significant burden on families, emotionally and financially."

Jennifer Hoffmann, MD, MS, senior author, emergency medicine physician at Ann & Robert H. Lurie Children's Hospital of Chicago and Assistant Professor of Pediatrics at Northwestern University Feinberg School of Medicine

Mark S. Johnson, a parent from Juneau, Alaska, described the challenges his family faced: "My 14-year-old stepson needed inpatient mental health treatment but there were no options available in Alaska. Our local hospital kept him under observation while we sought psychiatric placement for him in Washington, over 900 miles from our home. It was very stressful and visiting him every two weeks was expensive."

Dr. Hoffmann emphasized that early detection of mental health concerns and prevention of mental health emergencies in youth can be part of the solution to the psychiatric bed shortage. This can be accomplished in primary care and school-based health centers. She also stressed the need to support the 988 Suicide and Crisis Lifeline, which helps to address mental health crises via telephone and text messages.

"Other ways to improve access to youth mental health services could involve mobile mental health units and increased use of telehealth for rural areas," added Dr. Hoffmann.

Kenneth Michelson, MD, MPH, from Lurie Children's was a co-author on the study.