Emergency Department Behavioral Health Observation and Stabilization

AI Summary

Rising paediatric emergency visits and reduced inpatient psychiatric beds have increased boarding, prompting development of behavioural health observation models.
BHO provides time-limited, intensive psychiatric assessment and crisis stabilisation by a multidisciplinary team to reduce symptoms and clarify diagnosis.
Successful implementation requires clear patient selection, interdisciplinary collaboration, therapeutic interventions, operational planning, and structured disposition planning with measurable outcomes.

Child Adolesc Psychiatr Clin N Am. 2026 Jul;35(3):453-464. doi: 10.1016/j.chc.2026.03.011. Epub 2026 May 20.

ABSTRACT

Emergency department visits for pediatric mental health crises have risen sharply in recent years, while inpatient psychiatric bed capacity has declined, resulting in prolonged patient boarding. This article describes the development and implementation of behavioral health observation (BHO) models to address this gap in care. BHO provides time-limited, intensive psychiatric assessment and crisis stabilization with a multidisciplinary team focused on symptom reduction, diagnostic clarification, and structured disposition planning for patients. The article outlines patient selection, interdisciplinary collaboration, therapeutic interventions, operational considerations, early outcomes, and offers a practical framework to improve behavioral health care in the emergency crisis setting.

PMID:42297547 | DOI:10.1016/j.chc.2026.03.011

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