Social and Patient Factors Associated With Disposition Change in Pediatric Mental Health Boarding: A Retrospective Case-Control Study

Abstract

The current pediatric mental health crisis has resulted in an increase in boarding patients. We sought to understand the role of social factors in final disposition. A single-center retrospective case-control study was conducted. Patients <18 years old presenting for a mental health chief complaint and recommended for inpatient psychiatric treatment were included. Outcomes groups were (1) patients discharged to home or a lower level of care after re-evaluation and (2) patients transferred to an inpatient psychiatric facility. Univariate and multiple logistic regression analyses were conducted. Patient identification as LGBTQ+ (lesbian, gay, bisexual, transgender, queer, and questioning and the “+” is intended to signify inclusivity of individuals who are not heterosexual or cisgender) was associated with a lower likelihood of discharge to home or a lower level of care (odds ratio [OR] = 0.39, 95% confidence interval [CI] = 0.18-0.77). We identified additional factors that were associated with final disposition. Further investigation is needed to clarify these associations and to determine the impact of disposition on long-term mental health outcomes.