Spotlight on: Behavioral Health Emergency Department "Boarding"
What is "Boarding?"
Boarding occurs when a person in the Emergency Department (ED) requires inpatient psychiatric care, but there are no appropriate psychiatric placements available. Patients are often stuck waiting for weeks, even months, in hospital EDs, in non-psychiatric medical units, or at home.
There is a boarding crisis affecting the delivery of behavioral health care to children in Massachusetts, and research shows that children and teens are likely to board for longer periods of time than adults.
There are many reasons children may experience boarding, but one of the most important is that the pediatric behavioral health system is overwhelmed by demand, resulting in delayed and inconsistent treatment.
COVID-19 and "Boarding"
The COVID-19 pandemic and resulting mental health impacts have put significant stress an already overburdened system. From July-October 2020, Boston Children’s Hospital reported 277 youth patients boarding in the ED having suicidal thoughts or attempting suicide - a 47% increase over the same time period in 2019. With a lack of community-based urgent care options, the Emergency Department is the most accessible place to go for a family in need, however there continues to be a severe shortage of psychiatric beds.
How are we addressing the problem?
The Children's Mental Health Campaign is addressing the escalating boarding crisis through public awareness campaigns and legislative & budget advocacy.
We have partnered with legislators on several bills that expand behavioral health urgent care services, create a system of data collection, and establish expedited protocols for admitting patients under the age of 22.
In the FY22 budget, we're advocating for a 50M Innovation Fund to address behavioral health boarding through investment in resources, including: new inpatient beds, specialized training for staff, crisis stabilization services, increases in CBAT and partial hospitalization capacity.