P2.D080: Assessing Unmet Needs in Adolescents Boarding in the Emergency Department for Mental Health Conditions

Purpose/Objectives: Meeting the acute mental health care needs of adolescents presenting for mental health concerns continues to be a nationwide challenge. The surge in adolescents seeking mental health care, combined with limited access to acute mental health services (notably in rural areas), has led to a significant and continued rise in prolonged boarding of adolescents in the emergency department (ED). The purpose of this study was to assess the experiences and perspectives of adolescents who are boarding in a rural, general ED for mental health conditions.

Design/Methods: We conducted semi-structured interviews with adolescent patients aged 10-19 who were boarding (length of stay ≥ 24 hours) for mental health concerns. We designed an interview guide through an iterative process with key partners. We analyzed interview transcripts through thematic analysis using an a priori coding tree and measured inter-rater reliability.

Results: Analysis of interviews (n=14) revealed several key themes, including challenges posed by the ED environment, the impact of boarding on emotional well-being, and the importance of communication between adolescents and staff. Suggestions for improvement primarily revolved around enhancing access to activities and promoting social interaction.

Conclusion/Discussion: Adolescents encounter numerous challenges while boarding in a rural, general ED for mental health concerns. Based on these findings, future efforts that could potentially enhance the experience of adolescent patients boarding in the ED for mental health concerns include promoting socialization opportunities, developing hygiene kits, and coordinating efforts to improve access to schoolwork. Overall, enhanced access to mental health care services remains crucial in rural areas to mitigate the potential harmful effects of ED boarding self-reported by adolescents in our study.