A Pediatric Psychology Bridge Clinic as an Acute Care and Emergency Department Diversion Service

Background The needs of pediatric patients presenting to emergency departments for psychiatric complaints far exceed the capacity of available acute care services. A Pediatric Psychology Bridge Clinic was established to provide short-term care for patients while they await outpatient therapeutic services.Objective This study characterizes the demographics, clinical presentation, and recidivism of patients treated in this Bridge Clinic in an 18-month period.Method Data were gathered from a retrospective chart review of 74 patients referred to the Bridge Clinic. These patients were also compared to a matched sample of patients who were admitted to a psychiatric inpatient unit during the same time frame.Results The 74 Bridge Clinic patients ranged from 6 to 17 years old (M = 13.96; SD = 2.57); were predominantly female (61%); and predominantly White (40%) or Black (36%). The most common chief complaints at emergency department presentation were suicide/self-harm (73%) and aggression (20%). 88% of referred patients attended their scheduled Bridge intake appointment, and only 2 patients returned to the emergency department prior to the appointment. The Bridge Clinic and inpatient unit groups did not differ on chief complaint or on emergency department recidivism rates within 6 months. The average emergency department length of stay for Bridge Clinic patients (35 hours) was significantly shorter than for patients who were admitted to the inpatient unit (73 hours).Conclusions The current study demonstrates that a Bridge Clinic providing short-term access to mental healthcare is an effective way to reduce emergency department lengths of stay and provide therapeutic support to patients presenting with high levels of psychiatric acuity.