Adolescents’ Experiences During “Boarding” Hospitalization While Awaiting Inpatient Psychiatric Treatment Following Suicidal Ideation or Suicide Attempt
Open accessAbstract
BACKGROUND: Two million adolescents experience suicidal ideation (SI) or suicide attempt (SA) annually, and they frequently present to emergency departments. Delays in transfer to inpatient psychiatric units increasingly lead to “boarding” in emergency departments and inpatient medical units. We sought to understand adolescents’ perspectives during boarding hospitalizations to gain insight into helpful practices and targets for improvement. METHODS: Using convenience sampling, we conducted semistructured interviews with 27 adolescents hospitalized for SI or SA while they were awaiting transfer to an inpatient psychiatric facility. Interviews were recorded and transcribed, and the thematic analysis was organized using NVivo 11. RESULTS: Eight themes emerged: (1) supportive clinical interactions, (2) information needs, (3) repetitive inquiries, (4) safety, (5) previous hospital experiences, (6) activities and boredom, (7) physical comfort, and (8) emotions. Adolescents expressed appreciation for compassionate clinicians and for receiving information about what to expect, experienced the hospital as a safe environment, emphasized the value of staying occupied and of physical comfort, and were relieved to be receiving help to reduce their suicidal thoughts or behaviors. Reports of embarrassment and discomfort about repeated inquiries from the clinical team, comparisons with previous hospital experiences, and unanswered questions about what would occur during the planned inpatient psychiatric hospitalization were common. CONCLUSIONS: The perspectives of adolescents seeking care for SI or SA are an important source of information for health care systems seeking to improve hospital care. Clinicians can relieve distress of adolescents awaiting psychiatric hospitalization by focusing on compassionate connection, minimizing repeated inquiries, and providing complete and concrete information about treatment plans.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Hospitalization for Suicide Ideation or Attempt: 2008–2015
Plemmons, G., Hall, M., Doupnik, S., Gay, J., Brown, C., Browning, W., Casey, R., Freundlich, K., Johnson, D. P., Lind, C., et al. (2018) · Pediatrics · doi:10.1542/peds.2017-2426 · Cited by 405 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 19
- [3]Blader JC Acute inpatient care for psychiatric disorders in the United States, 1996 through 2007. Archives of General Psychiatry. 2011; 68(12): 1276– 1283. 21810629
- [4]Fieldston E, Jonas J, Scharko AM. Boarding of pediatric psychiatric patients is a no-fly zone for value. Hospital Pediatrics. 2014; 4(3): 133– 134. 24785554
- [5]Claudius I, Donofrio JJ, Lam CN, Santillanes G. Impact of boarding pediatric psychiatric patients on a medical ward. Hospital Pediatrics. 2014; 4(3): 125– 132. 24785553
- [6]Chun TH, Mace SE, & Katz ER Executive Summary: Evaluation and Management of Children and Adolescents With Acute Mental Health or Behavioral Problems. Part I: Common Clinical Challenges of Patients With Mental Health and/or Behavioral Emergencies. Pediatrics. 2016; 138(3): e20161571– e20161571. 27550980
- [7]Betz ME, & Boudreaux ED Managing Suicidal Patients in the Emergency Department. Annals of Emergency Medicine. 2016; 67(2): 276– 282. 26443554 PMC4724471
- [8]Kerkorian D, McKay M, Bannon WM. Seeking help a second time: parents’/caregivers’ characterizations of previous experiences with mental health services for their children and perception of barriers to future use. American Journal of Orthopsychiatry. 2006; 76(2): 161– 166. 16719634
- [9]Becker KD, Boustani M, Gellatly R, Chorpita BF. Forty Years of Engagement Research in Children’s Mental Health Services: Multidimensional Measurement and Practice Elements. Journal of Clincial Child and Adolescent Psychology. 2018; 47(1): 1– 23. 28574780
- [10]Gopalan G, Goldstein L, Klingenstein K, Sicher C, Blake C, McKay MM. Engaging families into child mental health treatment: updates and special considerations. Journal of the Canadian Academy of Child and Adolescent Psychiatry. 2010; 19(3): 182– 196. 20842273 PMC2938751
- [11]Olfson M, Wall M, Wang S, Suicide after deliberate self-harm in adolescents and young adults. Pediatrics. 2018; 141(4): e20173517. 29555689
- [12]Mollen CJ, Barg FK, Hayes KL, Gotcsik M, Blades NM, Schwarz DF. Adolescent input for designing an emergency department-based intervention about emergency contraception: results from an in-depth interview study. Pediatric Emergency Care. 2009; 25(10): 625– 628. 19834422
- [13]Mollen CJ, Fernando M, Hayes KL, Barg FK. Pregnancy, contraception and emergency contraception: the language of urban adolescent young women. Journal of Pediatric Adolescent Gynecology. 2012; 25(4): 238– 240. 22840933 PMC3408585
- [14]Zima BT, Rodean J, Hall M, Bardach NS, Coker TR, & Berry JG (2016). Psychiatric Disorders and Trends in Resource Use in Pediatric Hospitals. Pediatrics. 2016; 138(5): e20160909– e20160909. 27940773 PMC5079078
- [16]Feinstein JA, Russell S, DeWitt PE, Feudtner C, Dai D, Bennett TD. R Package for Pediatric Complex Chronic Condition Classification. JAMA Pediatr. 2018; 172(6): 596– 598. 29710063 PMC5933455
- [17]Strauss AL, Corbin JM. Basics of Qualitative Research: Grounded Theory Procedures and Techniques. Newbury Park, CA: Sage Publications, 1990 Print.
- [20]Kelly CM, Jorm AF, Kitchener BA. Development of mental health first aid guidelines on how a member of the public can support a person affected by a traumatic event: a Delphi study. BMC Psychiatry. 2010; 10(49). PMC2904289 20565918
- [21]Ambresin A, Bennett KB, Patton GC, Sanci LA, Sawyer SM. Assessment of youth-friendly health care: a systematic review of indicators drawn from young people’s perspectives. Journal of Adolescent Health. 2013; 52(6): 670– 681. 23701887
- [22]Britto MT, Gail BS, Robert FD, Specialists understanding of the health care preferences of chronically ill adolescents. Journal of Adolescent Health 2007; 40(4): 334– 341. 17367726
- [23]Byczkowski T, Linda MK, Maria TB. Family experiences with outpatient care: do adolescents and parents have the same perceptions? Journal of Adolescent Health. 2010; 47(1): 92– 98. 20547297
- [24]Viner RM. Do adolescent inpatient wards make a difference? Findings from a national young patient survey. Pediatrics. 2007; 120(4): 749– 755. 17908761
Cited by
Sorted by citations
Lindkvist, R.-M., Westling, S., Eberhard, S., Johansson, B. A., Rask, O., & Landgren, K. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19010300 · Cited by 26 · see citing works
Sams, D. P., Garrison, D., Walsh, P., Maeng, D., & Cross, W. (2023) · Child and Adolescent Mental Health · doi:10.1111/camh.12636 · Cited by 11 · see citing works
- Authors
- Worsley, D., Barrios, E., Shuter, M., Pettit, A. R., & Doupnik, S. K.
- Affiliations
- Center for Pediatric Clinical Effectiveness, PolicyLab, and Division of General Pediatrics and
- Children's Hospital of Philadelphia (US)
- Center for Public Health Initiatives and
- Leonard Davis Institute of Health Economics (US)
- Corresponding author
- Doupnik, Stephanie K.
- Venue
- Hospital Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2019-11-01
- Volume
- 9
- Issue
- 11
- Pages
- 827-833
- ISSN
- 2154-1663 (ISSN-L)
- 2154-1671
- PMC
- PMC7307268
- OpenAlex
- W2981679437
- Cited by
- 46
- References
- 1
- Citations by year
- 2026: 7 · 2025: 9 · 2024: 7 · 2023: 9 · 2022: 4 · 2021: 7 · 2020: 3
- FWCI
- 3.89
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Hospital Pediatrics (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (K23MH115162)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
- Keywords
- adolescent suicide, suicidal ideation, suicide attempts, boarding, emergency department hospitalization, adolescents' perceptions, patient experience, compassionate care, information needs, physical comfort, boredom, hospital safety
- MeSH terms
- Patient Comfort, Adolescent, Child, Emergency Service, Hospital, Female, Hospitalization, Humans, Interviews as Topic, Male, Patient Acceptance of Health Care, Patient Education as Topic, Patient Transfer, Physician-Patient Relations, Sampling Studies, Suicide, Attempted, Young Adult, Suicidal Ideation
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
