581 - Initial Assessment of the Johns Hopkins Hospital Pediatric Psychology Bridge Clinic

Poster Number: 581
Publication Number: 581.126

Robert J. Berg, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Sarah Radtke, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Eyad Ali, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Shivani Parulekar, Johns Hopkins University, Glen Rock, NJ, United States; Carisa Parrish, Children's Mercy Kansas City, Kansas City, MO, United States; Elizabeth Reynolds, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Mackenzie Sommerhalder, Johns Hopkins School of Medicine, Baltimore, MD, United States

Background: The number of children seeking psychiatric care in the emergency department (ED) has increased dramatically in the past decade and outstrips the capacity of acute care services. The Johns Hopkins Hospital (JHH) opened a Pediatric Psychology Bridge Clinic to provide short-term care for patients from the ED while they await access to therapeutic services (e.g., partial hospitalization programs, standard or intensive outpatient programs). The clinic’s primary objectives are to increase access to crisis intervention mental health services and to reduce the time patients spend waiting in the ED due to lack of close follow-up care.

Objective: This poster aims to summarize the demographics, presenting concerns, and recidivism of patients treated at the JHH Bridge Clinic from January 2021 to November 2022.

Design/Methods: This study is a retrospective chart review of 62 patients referred to the JHH Bridge Clinic. SPSS was used to determine descriptive and frequency statistics of the data.

Results: In the designated time frame, 62 patients were referred for Bridge Clinic appointments after their ED discharge. Of these patients, 56 (90.3%) attended at least one appointment, 3 (4.8%) returned to the ED prior to their clinic appointment, and 3 (4.8%) no showed their appointments and were not responsive to attempts to reschedule. The most common chief complaints at ED presentation were suicidal ideation (61%), aggression (19%), elopement (5%), and emotional dysregulation (5%). On average, patients’ initial Bridge Clinic appointment occurred 3 days after ED discharge and patients attended between 1 and 7 clinic appointments. Of those who followed up at the Bridge Clinic, 57% were female, 40% were male, and 3% identified as non-binary. Patient age ranged from 6 to 17-years-old (M = 13.96; SD = 2.75). ED recidivism was 11% at 1 month, 16% at 2 months, 24% at 3 months, and 29% at 6 months.

Conclusion(s):

These results provide initial evidence that a Bridge Clinic providing short-term access to mental healthcare is an effective way to provide psychiatric care to a particularly acute and vulnerable population. Future studies will explore whether any demographic or clinical variables predict ED recidivism for this population and will compare outcomes of patients who accessed the Bridge Clinic with demographically matched patients who did not.