Comparison of youth suicide with involuntary hold criteria and inpatient capacity

Abstract

BackgroundBoarding in emergency departments pending psychiatric admission significantly impacts both the patient and system. Current recommendations suggest increasing available inpatient beds, yet involuntary psychiatric admissions have not been widely correlated with improved patient outcomes. MethodsWe compared state-by-state youth suicide data clustered into 3-year intervals from 1999 to 2016 to psychiatric inpatient bed numbers and stringency on involuntary hold criteria using Poisson regression models. ResultsNo significant association was found between suicide rates and bed availability or hold criteria. ConclusionsWhile individual holds can be valuable in prevention of danger to self, on a population basis, the incident rate ratio of inpatient bed number and that of stringency of hold criteria was not significant when relevant variables were controlled. A focus on preventative strategies is imperative, given the equipoise for this current avenue of treatment.