The Impact of a Crisis Intervention Team Program on Psychiatric Boarding

Psychiatric boarding is the phenomenon of housing individuals in emergency departments while awaiting access to mental health services in the community. The expansion of psychiatric boarding is attributed to continued deinstitutionalization and under-resourcing of mental health services. Psychiatric boarding is also associated with deleterious outcomes for individuals in need of access to behavioral health services, facilities. There is limited research on programmatic efforts to reduce psychiatric boarding as it pertains to Crisis Intervention Team programs colocated in medical settings. Crisis Intervention Team (CIT) programs are community-based, multi-stakeholder partnerships that include dedicated assessment centers crisis response and referral. This study utilized a retrospective, comparative approach to test the hypothesis that CIT participation positively impacts psychiatric boarding outcomes versus boarded patients who were not CIT participants. Findings indicate that: a) CIT participants experienced reduced time in psychiatric boarding compared to non-participants, b) psychiatric boarding length of stay was reduced for all patients seen in the emergency department after the CIT program was implemented compared to before implementation, and that c) suicidal features and insurance did not impact length of stay but positive alcohol screens appeared to be associated with increased length. Study implications for research, practice and training, along with limitations and future directions, are also discussed