A new study has found that nearly 12% of pediatric emergency room visits for mental health conditions in 2022 resulted in children being “boarded” in the ER for three to seven days, waiting for placement in proper treatment programs. The study, published in JAMA Health Forum, analyzed Medicaid claims data from 44 states covering over 255,000 visits.
The findings confirm years of anecdotal reports that psychiatric boarding is a nationwide problem, particularly for children covered by Medicaid. Researchers found that boarding rates varied dramatically across the country, with some states having much higher rates than others. Oregon’s rate was above the national average.
The shortage of treatment options has left emergency departments as the fallback for pediatric mental health crises. Dr. Rebecca Marshall, who leads OHSU Doernbecher Children’s Hospital’s pediatric psychiatry consult service, said that patients are often told there’s no psychiatric bed available after expressing suicidal thoughts or severe depression. This can be disorienting and disappointing for youth and families, leading to feelings of limbo and sometimes worsening their mental health.
The study’s lead author, Dr. John McConnell, said that the findings point to a big gap in getting timely, appropriate care. He emphasized that the healthcare system has long treated mental health as an afterthought, giving it far less attention and funding than other conditions.
Oregon Health & Science University has taken steps to expand behavioral health services, including a $130 million investment in 2021. However, Marshall said those efforts haven’t kept pace with demand due to the state’s fragmented approach to funding behavioral health.
The study’s findings highlight the need for real change in the healthcare system, particularly accountability and measurable outcomes. Until then, emergency departments will continue to struggle with pediatric mental health crises, leaving children waiting for extended periods of time in unsuitable environments.
Source: https://www.oregonlive.com/health/2025/08/thousands-of-kids-in-mental-distress-are-stuck-in-ers-for-days-ohsu-study-finds.html