Amid an escalating national crisis in youth mental health, emergency department boarding times for children and adolescents have increased as they wait for behavioral health and psychiatric services. Clinicians strive to avert these boarding outcomes by expanding access to mental health support through innovative strategies, Funda Bachini, MD, division chief of psychiatry at Phoenix Children’s, told Becker’s.
Phoenix Children’s serves more than 278,000 patients annually. Its behavioral health sector offers services from outpatient counseling to inpatient care.
“There are really long wait times in the community to see a psychiatrist, waiting on average six months, which is really hard,” Dr. Bachini said. “If you’re at the point where you’ve reached out to a psychiatrist, you need help now, or else you wouldn’t be reaching out.”
Following the pandemic, Phoenix Children’s stationed psychiatric nurse practitioners in its emergency departments, allowing assessments and treatment — including medication — for children waiting for psychiatric services. At one time, there were nearly 24 children waiting for services, according to Dr. Bachini.
“The need definitely outweighs the supply of providers,” she said. “That’s a national trend. We see that locally in Arizona, but it happens everywhere.”
Mental health therapists were also put in place so patients with psychiatric and mental health needs are seen within two hours of entering the department. The hospital has created programs across the spectrum of mental health services to address the influx of children entering emergency departments.
Many treatment options include either the highest level of care — including inpatient — or outpatient services that may have a six-month waitlist.
The hospital has developed a bridge clinic that helps patients after discharge from the emergency room, psychiatric services and Suicide Prevention Program team to connect with a Phoenix Children’s health provider while plans for long-term care are formed. This “bridge” allows patients to meet with providers as needed — which is daily in some cases — and decreases the number of former bridge clinic patients returning to the emergency department.
“Sometimes when you come to the emergency department, you don’t need to go inpatient, but you also can’t wait that amount of time,” Dr. Bachini said. “The bridge clinic [has] therapists and psychiatrists who can see you within one to two days and then see you at increased frequency, so you don’t have to sit around and wait in the ER and you have some sort of intervention.”
