Impact of mental health boarding on clinicians at a children's hospital: A qualitative analysis

The child and adolescent mental health boarding crisis (i.e., prolonged stays in acute care hospitals for patients awaiting mental health treatment) continues to challenge acute care hospital staff and resources. We sought to understand clinician's experiences while caring for patients experien...

Full description

Saved in:
Bibliographic Details
Published inJournal of hospital medicine Vol. 19; no. 3; pp. 193 - 199
Main Authors Worsley, Diana, Bowden, Cadence, Keating, Cameron, Cassidy, Kyla, Doupnik, Stephanie K
Format Journal Article
LanguageEnglish
Published United States Frontline Medical Communications 01.03.2024
Subjects
Online AccessGet full text

Cover

Loading…
Abstract The child and adolescent mental health boarding crisis (i.e., prolonged stays in acute care hospitals for patients awaiting mental health treatment) continues to challenge acute care hospital staff and resources. We sought to understand clinician's experiences while caring for patients experiencing mental health boarding. We conducted semistructured qualitative interviews with clinicians who care for patients experiencing mental health boarding in an acute care freestanding children's hospital with no inpatient psychiatric unit. We used an inductive approach to determine interview themes and major findings. The study included 48 clinician participants from diverse specialties, including 13 social workers, 11 nurses, five psychiatric technicians, six pediatric residents, four attending pediatric hospitalists, four attending psychiatrists, one psychologist, and four other mental health specialists. We identified emergent themes in five domains: (1) frustrations with the mental healthcare system, (2) lack of training in mental healthcare skills, (3) feelings of helplessness, (4) ineffectiveness of medical model of care during mental health boarding, and (5) resilience and support factors. Caring for patients with mental health boarding has negative effects on clinicians, and health system efforts to prevent boarding could improve workforce retention and reduce burnout.
AbstractList BackgroundThe child and adolescent mental health boarding crisis (i.e., prolonged stays in acute care hospitals for patients awaiting mental health treatment) continues to challenge acute care hospital staff and resources. We sought to understand clinician's experiences while caring for patients experiencing mental health boarding.MethodsWe conducted semistructured qualitative interviews with clinicians who care for patients experiencing mental health boarding in an acute care freestanding children's hospital with no inpatient psychiatric unit. We used an inductive approach to determine interview themes and major findings.ResultsThe study included 48 clinician participants from diverse specialties, including 13 social workers, 11 nurses, five psychiatric technicians, six pediatric residents, four attending pediatric hospitalists, four attending psychiatrists, one psychologist, and four other mental health specialists. We identified emergent themes in five domains: (1) frustrations with the mental healthcare system, (2) lack of training in mental healthcare skills, (3) feelings of helplessness, (4) ineffectiveness of medical model of care during mental health boarding, and (5) resilience and support factors.ConclusionsCaring for patients with mental health boarding has negative effects on clinicians, and health system efforts to prevent boarding could improve workforce retention and reduce burnout.
Abstract Background The child and adolescent mental health boarding crisis (i.e., prolonged stays in acute care hospitals for patients awaiting mental health treatment) continues to challenge acute care hospital staff and resources. We sought to understand clinician's experiences while caring for patients experiencing mental health boarding. Methods We conducted semistructured qualitative interviews with clinicians who care for patients experiencing mental health boarding in an acute care freestanding children's hospital with no inpatient psychiatric unit. We used an inductive approach to determine interview themes and major findings. Results The study included 48 clinician participants from diverse specialties, including 13 social workers, 11 nurses, five psychiatric technicians, six pediatric residents, four attending pediatric hospitalists, four attending psychiatrists, one psychologist, and four other mental health specialists. We identified emergent themes in five domains: (1) frustrations with the mental healthcare system, (2) lack of training in mental healthcare skills, (3) feelings of helplessness, (4) ineffectiveness of medical model of care during mental health boarding, and (5) resilience and support factors. Conclusions Caring for patients with mental health boarding has negative effects on clinicians, and health system efforts to prevent boarding could improve workforce retention and reduce burnout.
The child and adolescent mental health boarding crisis (i.e., prolonged stays in acute care hospitals for patients awaiting mental health treatment) continues to challenge acute care hospital staff and resources. We sought to understand clinician's experiences while caring for patients experiencing mental health boarding. We conducted semistructured qualitative interviews with clinicians who care for patients experiencing mental health boarding in an acute care freestanding children's hospital with no inpatient psychiatric unit. We used an inductive approach to determine interview themes and major findings. The study included 48 clinician participants from diverse specialties, including 13 social workers, 11 nurses, five psychiatric technicians, six pediatric residents, four attending pediatric hospitalists, four attending psychiatrists, one psychologist, and four other mental health specialists. We identified emergent themes in five domains: (1) frustrations with the mental healthcare system, (2) lack of training in mental healthcare skills, (3) feelings of helplessness, (4) ineffectiveness of medical model of care during mental health boarding, and (5) resilience and support factors. Caring for patients with mental health boarding has negative effects on clinicians, and health system efforts to prevent boarding could improve workforce retention and reduce burnout.
The child and adolescent mental health boarding crisis (i.e., prolonged stays in acute care hospitals for patients awaiting mental health treatment) continues to challenge acute care hospital staff and resources. We sought to understand clinician's experiences while caring for patients experiencing mental health boarding.BACKGROUNDThe child and adolescent mental health boarding crisis (i.e., prolonged stays in acute care hospitals for patients awaiting mental health treatment) continues to challenge acute care hospital staff and resources. We sought to understand clinician's experiences while caring for patients experiencing mental health boarding.We conducted semistructured qualitative interviews with clinicians who care for patients experiencing mental health boarding in an acute care freestanding children's hospital with no inpatient psychiatric unit. We used an inductive approach to determine interview themes and major findings.METHODSWe conducted semistructured qualitative interviews with clinicians who care for patients experiencing mental health boarding in an acute care freestanding children's hospital with no inpatient psychiatric unit. We used an inductive approach to determine interview themes and major findings.The study included 48 clinician participants from diverse specialties, including 13 social workers, 11 nurses, five psychiatric technicians, six pediatric residents, four attending pediatric hospitalists, four attending psychiatrists, one psychologist, and four other mental health specialists. We identified emergent themes in five domains: (1) frustrations with the mental healthcare system, (2) lack of training in mental healthcare skills, (3) feelings of helplessness, (4) ineffectiveness of medical model of care during mental health boarding, and (5) resilience and support factors.RESULTSThe study included 48 clinician participants from diverse specialties, including 13 social workers, 11 nurses, five psychiatric technicians, six pediatric residents, four attending pediatric hospitalists, four attending psychiatrists, one psychologist, and four other mental health specialists. We identified emergent themes in five domains: (1) frustrations with the mental healthcare system, (2) lack of training in mental healthcare skills, (3) feelings of helplessness, (4) ineffectiveness of medical model of care during mental health boarding, and (5) resilience and support factors.Caring for patients with mental health boarding has negative effects on clinicians, and health system efforts to prevent boarding could improve workforce retention and reduce burnout.CONCLUSIONSCaring for patients with mental health boarding has negative effects on clinicians, and health system efforts to prevent boarding could improve workforce retention and reduce burnout.
Author Bowden, Cadence
Keating, Cameron
Worsley, Diana
Doupnik, Stephanie K
Cassidy, Kyla
Author_xml – sequence: 1
  givenname: Diana
  orcidid: 0000-0003-0471-242X
  surname: Worsley
  fullname: Worsley, Diana
  organization: Division of General Pediatrics, Clinical Futures, and PolicyLab, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
– sequence: 2
  givenname: Cadence
  orcidid: 0000-0001-5297-9933
  surname: Bowden
  fullname: Bowden, Cadence
  organization: Division of General Pediatrics, Clinical Futures, and PolicyLab, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
– sequence: 3
  givenname: Cameron
  surname: Keating
  fullname: Keating, Cameron
  organization: Division of General Pediatrics, Clinical Futures, and PolicyLab, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
– sequence: 4
  givenname: Kyla
  surname: Cassidy
  fullname: Cassidy, Kyla
  organization: Division of General Pediatrics, Clinical Futures, and PolicyLab, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
– sequence: 5
  givenname: Stephanie K
  orcidid: 0000-0002-7022-9930
  surname: Doupnik
  fullname: Doupnik, Stephanie K
  organization: Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
BackLink https://www.ncbi.nlm.nih.gov/pubmed/38340351$$D View this record in MEDLINE/PubMed
BookMark eNpdkE1LxDAQhoMofqwe_AMS8KAeVqeZJDbeRPyCBS96Lmma2ixpsjat4L8369fB07wMz7wMzx7ZDDFYQg4LOC8A2MWy688LRIANslsIgXMhQW7-ZqHYDtlLaQnAsRR8m-xgiRxQFLukeuxX2ow0trS3YdSedlb7saN11EPjwiuNgRrvgjNOh0T1SDU1nfPNYMNJol1MK5fPrug1fZu0z3l075bqoP1HcmmfbLXaJ3vwM2fk5e72-eZhvni6f7y5XswNu8RxzuQlUwxYIUxZAmqspWmhAV2XaCQHrspa1SqvGsFQGSlr2TKosYGSWyVxRk6_e1dDfJtsGqveJWO918HGKVW5nSuVQZ7R43_oMk5D_ndNIaISvFxTZ9-UGWJKg22r1eB6PXxUBVRr61W2Xn1Zz-zRT-NU97b5I3814ycGgn0w
Cites_doi 10.1097/PEC.0b013e3181bec82f
10.1016/j.acap.2019.05.132
10.1177/13674935211001222
10.3390/ijerph13060618
10.1016/j.jaclp.2023.06.003
10.1016/j.annemergmed.2023.06.003
10.1016/j.annemergmed.2021.04.025
10.1111/camh.12638
10.1097/ACM.0000000000003912
10.1542/hpeds.2019-0043
10.1542/peds.2020-1174
10.1016/j.annemergmed.2019.07.004
10.1542/hpeds.2022-006913
10.1097/ACM.0000000000000655
10.1111/acem.13670
10.1111/jocn.16461
10.1542/peds.2018-2192
10.1007/s10488-022-01249-4
10.1097/ACM.0000000000000405
10.1016/j.jcjq.2023.06.017
10.1177/1751143719842794
10.1016/j.chc.2021.08.001
10.1007/s10995-023-03708-2
10.1097/PEC.0000000000001244
10.1001/jamapediatrics.2019.5991
ContentType Journal Article
Copyright 2024 Society of Hospital Medicine.
2024 Society of Hospital Medicine
Copyright_xml – notice: 2024 Society of Hospital Medicine.
– notice: 2024 Society of Hospital Medicine
DBID NPM
AAYXX
CITATION
K9.
7X8
DOI 10.1002/jhm.13300
DatabaseName PubMed
CrossRef
ProQuest Health & Medical Complete (Alumni)
MEDLINE - Academic
DatabaseTitle PubMed
CrossRef
ProQuest Health & Medical Complete (Alumni)
MEDLINE - Academic
DatabaseTitleList ProQuest Health & Medical Complete (Alumni)
CrossRef
PubMed
MEDLINE - Academic
Database_xml – sequence: 1
  dbid: NPM
  name: PubMed
  url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
  sourceTypes: Index Database
DeliveryMethod fulltext_linktorsrc
Discipline Medicine
EISSN 1553-5606
EndPage 199
ExternalDocumentID 10_1002_jhm_13300
38340351
Genre Journal Article
GrantInformation_xml – fundername: NIMH NIH HHS
  grantid: K23 MH115162
GroupedDBID ---
05W
1OC
31~
33P
3WU
4.4
5GY
66C
8-1
8UM
AAESR
AAFWJ
AAHHS
AANLZ
AAQQT
AAWTL
AAZKR
ABIJN
ABJNI
ABOCM
ABQWH
ACBWZ
ACCFJ
ACCZN
ACGOF
ACXQS
ADBTR
AEEZP
AEIGN
AENEX
AEQDE
AERZD
AEUYR
AFBPY
AFFPM
AFZJQ
AHBTC
AHMBA
AITYG
AIWBW
AJBDE
ALMA_UNASSIGNED_HOLDINGS
ALUQN
ASPBG
AVWKF
AZFZN
AZVAB
BDRZF
BFHJK
BHBCM
BRXPI
C45
CS3
DCZOG
DR2
DU5
EBS
EJD
EMOBN
F5P
FEDTE
G-S
GODZA
HF~
HGLYW
HVGLF
HZ~
IX1
LAW
LH4
LW6
MEWTI
MY~
NNB
NPM
OIG
OVD
P2P
PQQKQ
ROL
RQU
RYL
SUPJJ
TEORI
W99
WBKPD
WXSBR
WYUIH
XV2
AAYXX
CITATION
K9.
7X8
ID FETCH-LOGICAL-c273t-2672920215c8803a3b6cf0d0ab83c640498b9b9f0dd5239c66b6f20b3d084e963
ISSN 1553-5592
1553-5606
IngestDate Sat Nov 02 16:45:24 EDT 2024
Thu Oct 10 16:00:33 EDT 2024
Fri Aug 23 03:51:06 EDT 2024
Sat Nov 02 12:26:47 EDT 2024
IsPeerReviewed true
IsScholarly true
Issue 3
Language English
License 2024 Society of Hospital Medicine.
LinkModel OpenURL
MergedId FETCHMERGED-LOGICAL-c273t-2672920215c8803a3b6cf0d0ab83c640498b9b9f0dd5239c66b6f20b3d084e963
Notes ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ORCID 0000-0003-0471-242X
0000-0001-5297-9933
0000-0002-7022-9930
PMID 38340351
PQID 2933395484
PQPubID 1006405
PageCount 7
ParticipantIDs proquest_miscellaneous_2924999634
proquest_journals_2933395484
crossref_primary_10_1002_jhm_13300
pubmed_primary_38340351
PublicationCentury 2000
PublicationDate 2024-Mar
2024-03-00
20240301
PublicationDateYYYYMMDD 2024-03-01
PublicationDate_xml – month: 03
  year: 2024
  text: 2024-Mar
PublicationDecade 2020
PublicationPlace United States
PublicationPlace_xml – name: United States
– name: Hoboken
PublicationTitle Journal of hospital medicine
PublicationTitleAlternate J Hosp Med
PublicationYear 2024
Publisher Frontline Medical Communications
Publisher_xml – name: Frontline Medical Communications
References e_1_2_8_28_1
e_1_2_8_29_1
e_1_2_8_24_1
e_1_2_8_25_1
e_1_2_8_26_1
e_1_2_8_27_1
e_1_2_8_3_1
e_1_2_8_2_1
e_1_2_8_5_1
e_1_2_8_4_1
e_1_2_8_7_1
e_1_2_8_6_1
e_1_2_8_9_1
e_1_2_8_8_1
e_1_2_8_20_1
e_1_2_8_21_1
e_1_2_8_22_1
e_1_2_8_23_1
Pendry PS (e_1_2_8_15_1) 2007; 25
e_1_2_8_17_1
e_1_2_8_18_1
e_1_2_8_19_1
e_1_2_8_13_1
e_1_2_8_14_1
e_1_2_8_16_1
e_1_2_8_10_1
e_1_2_8_31_1
e_1_2_8_11_1
e_1_2_8_12_1
e_1_2_8_30_1
References_xml – ident: e_1_2_8_5_1
  doi: 10.1097/PEC.0b013e3181bec82f
– ident: e_1_2_8_10_1
  doi: 10.1016/j.acap.2019.05.132
– ident: e_1_2_8_20_1
  doi: 10.1177/13674935211001222
– ident: e_1_2_8_28_1
  doi: 10.3390/ijerph13060618
– ident: e_1_2_8_6_1
– ident: e_1_2_8_8_1
  doi: 10.1016/j.jaclp.2023.06.003
– ident: e_1_2_8_17_1
  doi: 10.1016/j.annemergmed.2023.06.003
– ident: e_1_2_8_22_1
– ident: e_1_2_8_19_1
  doi: 10.1016/j.annemergmed.2021.04.025
– ident: e_1_2_8_3_1
  doi: 10.1111/camh.12638
– ident: e_1_2_8_23_1
  doi: 10.1097/ACM.0000000000003912
– ident: e_1_2_8_21_1
  doi: 10.1542/hpeds.2019-0043
– ident: e_1_2_8_7_1
  doi: 10.1542/peds.2020-1174
– ident: e_1_2_8_11_1
  doi: 10.1016/j.annemergmed.2019.07.004
– ident: e_1_2_8_18_1
  doi: 10.1542/hpeds.2022-006913
– ident: e_1_2_8_24_1
  doi: 10.1097/ACM.0000000000000655
– ident: e_1_2_8_13_1
  doi: 10.1111/acem.13670
– volume: 25
  start-page: 217
  issue: 4
  year: 2007
  ident: e_1_2_8_15_1
  article-title: Moral distress: recognizing it to retain nurses
  publication-title: Nurs Econ
  contributor:
    fullname: Pendry PS
– ident: e_1_2_8_31_1
  doi: 10.1111/jocn.16461
– ident: e_1_2_8_4_1
  doi: 10.1542/peds.2018-2192
– ident: e_1_2_8_9_1
  doi: 10.1007/s10488-022-01249-4
– ident: e_1_2_8_25_1
  doi: 10.1097/ACM.0000000000000405
– ident: e_1_2_8_16_1
  doi: 10.1016/j.jcjq.2023.06.017
– ident: e_1_2_8_27_1
  doi: 10.1177/1751143719842794
– ident: e_1_2_8_2_1
  doi: 10.1016/j.chc.2021.08.001
– ident: e_1_2_8_30_1
  doi: 10.1007/s10995-023-03708-2
– ident: e_1_2_8_12_1
  doi: 10.1097/PEC.0000000000001244
– ident: e_1_2_8_14_1
  doi: 10.1001/jamapediatrics.2019.5991
– ident: e_1_2_8_29_1
– ident: e_1_2_8_26_1
SSID ssj0043854
Score 2.3447554
Snippet The child and adolescent mental health boarding crisis (i.e., prolonged stays in acute care hospitals for patients awaiting mental health treatment) continues...
Abstract Background The child and adolescent mental health boarding crisis (i.e., prolonged stays in acute care hospitals for patients awaiting mental health...
BackgroundThe child and adolescent mental health boarding crisis (i.e., prolonged stays in acute care hospitals for patients awaiting mental health treatment)...
SourceID proquest
crossref
pubmed
SourceType Aggregation Database
Index Database
StartPage 193
SubjectTerms Hospitals
Mental health
Pediatrics
Title Impact of mental health boarding on clinicians at a children's hospital: A qualitative analysis
URI https://www.ncbi.nlm.nih.gov/pubmed/38340351
https://www.proquest.com/docview/2933395484
https://www.proquest.com/docview/2924999634
Volume 19
hasFullText 1
inHoldings 1
isFullTextHit
isPrint
link http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1Lb9QwELaWIiEuiDdbCjIIiQNKcTyOk3CrtqACKgfUit4iOw9ViE2qblYIfgM_mnH8SMpSqXCJVt54nc18-WYmngchL6pGZ3FSNVFWJjwSSkKEaiFHLwU0AKqkODEJzoef5MGx-HCSnMxmvyZRS-te75Y__5pX8j9SxTGUq8mS_QfJhh_FAfyM8sUjShiPV5Lx-5DiuJxmNb7SnZG7CWduXeojgmBl8hZVyN62nVRc1xCbn24TLG0lcOWKlVxivPqJG3vzX7rwGnwfFx3d_e67Y7iFGtqYjkyvetdXZaGW9fkYFrBAu94FB3_88U1N309wMQZoeUpNIEK_xXJuPRmTTF7g4XyCN5iQamx7KDr9HNuGShvUb0vJfj1d7qLbzdio3_ye_h9qLwQj2sLNvMCpxTD1GrnOkbZMgOD-51CMTEA29NQL_8fXqWL8dVj1onVzicsymC5Ht8ktJza6ZwF0h8zq9i65cegkd48UFke0a6jFEbU4oh5HtGvpiCOqeqqox9HLFfVgeEP36ARD1GPoPjl-9_ZocRC5xhtRidZsH3GZmiZm-JyWSO-gQMuyYRVTOoNSCnQqM53rHIeqhENeSqllw5mGimWiRkp_QLbarq0fERrLFBIFMm10jbZjqpSqkrhhkKKxnYt0Tp77G1ac2foqxYZA5mTH38rCPX6rAu1UAFOuUMzJs_A1kqPZ8VJt3a3NOXzw6AHPeWhFEFaBDITZRt--yhU8JjdHbO-Qrf58XT9Ba7TXTweQ_AYfXYoT
link.rule.ids 315,783,787,27938,27939
linkProvider Wiley-Blackwell
openUrl ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Impact+of+mental+health+boarding+on+clinicians+at+a+children%27s+hospital%3A+A+qualitative+analysis&rft.jtitle=Journal+of+hospital+medicine&rft.au=Worsley%2C+Diana&rft.au=Bowden%2C+Cadence&rft.au=Keating%2C+Cameron&rft.au=Cassidy%2C+Kyla&rft.date=2024-03-01&rft.issn=1553-5592&rft.eissn=1553-5606&rft.volume=19&rft.issue=3&rft.spage=193&rft.epage=199&rft_id=info:doi/10.1002%2Fjhm.13300&rft.externalDBID=n%2Fa&rft.externalDocID=10_1002_jhm_13300
thumbnail_l http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1553-5592&client=summon
thumbnail_m http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1553-5592&client=summon
thumbnail_s http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1553-5592&client=summon