Evaluating Short-Stay Admissions and Referral to Pediatric Liaison Psychiatry: A Mixed-Methods Study in a Tertiary Hospital in Ireland.

Children and adolescents increasingly present to pediatric emergency departments (EDs) with acute mental health difficulties, yet short-stay pediatric liaison psychiatry (PLP) admissions remain poorly characterized. To characterize the demographic, clinical, and service features of short-stay PLP admissions (≤24 hours) in a tertiary pediatric hospital; compare them with longer admissions (>24 hours); and explore multidisciplinary clinicians’ perspectives on their management. A mixed-methods study was conducted comprising a retrospective review of all PLP admissions between January 2024 and August 2025, alongside qualitative interviews and focus groups with frontline PLP, ED, and social work clinicians (n=16). Of 529 admissions, 213 (40.3%) were short-stay. These admissions were predominantly emergency-driven (67.1%), commonly assessed in the ED (65.7%), and frequently occurred out of hours (51.2%). Compared with longer admissions, short-stay patients were significantly more likely to present with self-harm or suicidality (65.3% vs 29.4%, p<.001), behavioral and externalizing difficulties (17.8% vs 10.1%, p<.001), aggression during admission (22.5% vs 10.4%, p<.001), and to be new referrals (85.9% vs 73.4%, p<.001). Although nearly 70% were not previously known to Child and Adolescent Mental Health Services, almost three-quarters were discharged with specialist mental health follow-up. Qualitative findings positioned the ED as the default site of youth mental health crisis care and an informal gateway to specialist services, highlighting environmental and safety mismatches. Short-stay admissions represent high-acuity youth mental health crises rather than low-impact encounters, underscoring the need for investment in multidisciplinary crisis pathways, workforce capacity, and alternative models of care.