A Clarion Call: COVID-19 and the Pediatric Behavioral Health Inpatient Crisis

Authors: Benjamin W. Frush, MD, MA


The crises occasioned by the coronavirus disease 2019 (COVID-19) pandemic on medical centers have by this point been seemingly exhaustively documented. The ebbs and flows of the virus have caused at various times surging inpatient numbers, equipment shortages, and significant provider attrition, among other challenges.1–3 Lost amidst this discourse, however, is another crisis, present before the pandemic, which has now reached a fever pitch for those patients and clinicians caught in its midst: the inpatient pediatric behavioral health crisis.
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1. Kadri SS, Sun J, Lawandi A, et al. Association between caseload surge and COVID-19 survival in 558 U.S. hospitals, March to August 2020. Ann Intern Med 2021;174:1240–1251.
2. Raudenská J, Steinerová V, Javůrková A, et al. Occupational burnout syndrome and post-traumatic stress among healthcare professionals during the novel coronavirus disease 2019 (COVID-19) pandemic. Best Pract Res Clin Anaesthesiol 2020;34:553–560.
3. Saran S, Gurjar M, Baronia AK, et al. Personal protective equipment during COVID-19 pandemic: a narrative review on technical aspects. Expert Rev Med Devices 2020;17:1265–1276.
4. American Academy of Pediatrics-American Academy of Child and Adolescent Psychiatry-Children’s Hospital Association. Declaration of a national emergency in child and adolescent mental health. Published October 19, 2021. Accessed May 18, 2022.
5. Abramson A. 2022 Trends Report. Children’s mental health is in crisis. Published January 1, 2022. Accessed May 18, 2022.
6. Golberstein E, Wen H, Miller BF. Coronavirus disease 2019 (COVID-19) and mental health for children and adolescents. JAMA Pediatr 2020;174: 819–820.
7. Leeb RT, Bitsko RH, Radhakrishnan L, et al. Mental health-related emergency department visits among children aged <18 years during the COVID-19 pandemic—United States, January 1-October 17, 2020. Morb Mortal Wkly Rep 2020;69:1675–1680.
8. Pelletier JH, Rakkar J, Au AK, et al. Trends in US pediatric hospital admissions in 2020 compared with the decade before the COVID-19 pandemic. JAMA Netw Open 2021;4:e2037227.
9. Krass P, Dalton E, Doupnik SK, et al. US pediatric emergency department visits for mental health conditions during the COVID-19 pandemic. JAMA Netw Open 2021;4:e218533.
10. Bardach NS, Coker TR, Zima BT, et al. Common and costly hospitalizations for pediatric mental health disorders. Pediatrics 2014;133:602–609.
11. Beck J, Randall CL, Bassett HK, et al. Moral distress in pediatric residents and pediatric hospitalists: sources and association with burnout. Acad Pediatr 2020;20:1198–1205.
12. LaLonde L, Bruni T, Lancaster B, et al. The association between burnout and pediatrician management of adolescent depression. J Prim Care Community Health 2020;11:2150132720943335.
13. Herndon AC, Williams D, Hall M, et al. Costs and reimbursements for mental health hospitalizations at children’s hospitals. J Hosp Med 2020;15: 727–730.
14. Bowden CF, True G, Cullen SW, et al. Treating pediatric and geriatric patients at risk of suicide in general emergency departments: perspectives from emergency department clinical leaders. Ann Emerg Med 2021;78: 628–636.
15. Foster AA, Sundberg M, Williams DN, et al. Emergency department staff perceptions about the care of children with mental health conditions. Gen Hosp Psychiatry 2021;73:78–83.
16. Uong AM, Cabana MD, Serwint JR, et al. Changes in pediatric faculty burnout during the COVID-19 pandemic. Hosp Pediatr 2021Dec:hpeds. 2021-006045.
17. Alkhamees AA, Assiri H, Alharbi HY, et al. Burnout and depression among psychiatry residents during COVID-19 pandemic. Hum Resour Health 2021; 19:46.
18. Gill PJ, Anwar MR, Thavam T, et al. Identifying conditions with high prevalence, cost, and variation in cost in US children’s hospitals. JAMA Netw Open 2021;4:e2117816.
19. Sheridan DC, Sheridan J, Johnson KP, et al. The effect of a dedicated psychiatric team to pediatric emergency mental health care. J Emerg Med 2016;50:e121–e128.
20. Reliford A, Adebanjo B. Use of telepsychiatry in pediatric emergency room to decrease length of stay for psychiatric patients, improve resident on-call burden, and reduce factors related to physician burnout. Telemed J E Health 2019;25:828–832.
21. Poynter SE, McNeal-Trice K, Gonzalez Del Rey J. Addressing the behavioral and mental health educational gap in pediatric residency training. Pediatrics 2020;146:e20200805.