Management of High Acuity Patients in Pediatric Medical Settings: The Role of Consultation/Liaison Psychologists During the Growing Mental Health Crisis

Abstract

Since the onset of the COVID-19 pandemic, consultation/liaison (C/L) psychologists had to drastically shift their practices to care for psychiatrically acute pediatric patients admitted to medical settings. The aim of the current study was to provide an updated state of the field surrounding these changes and their implications for clinical practice. Psychologists and psychology post-doctoral fellows completed an anonymous, 51-item survey distributed via a national professional organization listserv. The results review responses, by percentages, about C/L team composition and practice patterns, as they relate to suicide risk assessments, transfers to inpatient psychiatric and other levels of care, intervention for boarding patients, and disposition and safety planning. Thematically coded qualitative responses regarding impact and management of high acuity patients are also summarized. The state of the field outlined by this survey suggests an increase in C/L assessments and interventions delivered to pediatric patients with acute psychiatric needs, as well as a reverberating effects on provider wellness. Ensuring providers establish competency for this subset of patients is vital to the continued provision of optimal patient care and to sustained provider wellness. Considerations for the field are explored.