Research highlights the nationwide need for psychiatric care for children

A study led by Children's Hospital Los Angeles found wide variation in pediatric inpatient psychiatric beds across the United States. It highlights the growing concerns about the demand and access to mental health services for children and the geographic disparities in the availability of inpatient psychiatric care.

The study, "Pediatric Inpatient Psychiatric Capacity in the U.S., 2017 to 2020," was published in JAMA Pediatrics.

The study evaluated U.S. pediatric inpatient psychiatric capacity and identified state-level variation in pediatric inpatient psychiatric beds from 2017 to 2020. The research found more than 90% of pediatric inpatient psychiatric beds were located in urban areas, raising concerns about access for rural children.

Lead study author, Anna Cushing, MD, an attending physician in the Division of Emergency and Transport Medicine at Children's Hospital Los Angeles, and a team of researchers, analyzed the findings and found that there was no change to the U.S. pediatric inpatient psychiatric bed capacity, despite the increases in pediatric mental health emergency visits.

"We're seeing a greater need for mental health services for children nationwide, and children increasingly having to wait in the emergency room for long periods of time because there are not enough inpatient psychiatric beds available," Cushing said.

"All children should have access to high quality mental health care regardless of where they live, their household income or their background."

The research methodology included a cross-sectional analysis of hospitals in the American Hospital Association Survey Database from 2017 to 2020 that reported having pediatric inpatient psychiatric beds. It estimated changes in hospitals with pediatric inpatient psychiatric beds and overall bed counts.

Key research findings between 2017 to 2020 show:

• This national study found no significant increase in the availability of inpatient pediatric psychiatric beds since 2017
• A child's access to pediatric inpatient psychiatric beds varies widely by state—from zero pediatric inpatient psychiatric beds in Alaska to 75 beds per 100,000 children in Arkansas
• Almost 89% of hospitals with inpatient pediatric psychiatric beds were located in cities—meaning kids in rural areas have to travel long distances to receive care
• About half of inpatient pediatric psychiatric beds were in free-standing psychiatric hospitals
• 17% of inpatient pediatric psychiatric beds were in children's psychiatric hospitals
• 23% of inpatient pediatric psychiatric beds were in hospitals specializing in pediatric care

"While the study sheds light into the geographic variation in pediatric inpatient psychiatric beds, we need more research on the impact this has on children and their families," Cushing said.

"We need to think creatively as a health care system about how we can ensure children who live in areas with fewer pediatric mental health care resources can access needed care, including through alternative care models such as community crisis services and telehealth consultation with pediatric mental health specialists."