WEDNESDAY, Aug. 20, 2025 (HealthDay News) -- Boarding is a considerable issue for Medicaid-enrolled youths seeking mental health care in emergency departments (EDs), according to a research letter published online Aug. 15 in JAMA Health Forum.
K. John McConnell, Ph.D., from the Oregon Health & Science University in Portland, and colleagues investigated the prevalence of and variations in boarding (spanning two to six midnights) for ED visits for mental health conditions among Medicaid-enrolled youths (aged 5 to 17 years) in 2022. The analysis included 255,139 ED visits for mental health conditions.
The researchers found that more than one in 10 ED visits (11.9 percent) resulted in three to seven days of boarding (mean, 4.5 days). Among individuals with primary diagnoses of suicide-related behaviors and depressive disorders, boarding was prevalent. There was substantial variation in boarding rates across states, with those in the bottom quintile having rates below 7.6 percent and those in the highest quintile above 15.4 percent. The lowest rate of mental health ED visits resulting in a boarding event was seen in Arkansas (2.7 percent), while Iowa had the highest (27.3 percent). Boarding occurred in more than one in five visits in Montana, North Carolina, Maine, Florida, and Iowa (21.8 to 27.3 percent).
"Boarding poses a substantial emotional toll on patients, families, and staff; it also may result in challenges related to patient and staff safety and restraint use, and it suggests an inability to find timely and appropriate care for youths in crisis," the authors write.