#273 Hidden in plain sight; overlooked and uncounted: paediatric psychiatry and boarding in Ireland

<h3>Introduction</h3> Children presenting to the emergency department with psychiatric complaints in Ireland often require in-patient treatment, particularly as access to on call psychiatry and adolescent inpatient care is limited. At present demand for psychiatric beds frequently exceeds supply, forcing clinicians to admit paediatric patients to general medical wards. This practice is referred to in international papers as ‘psychiatric boarding’ and can lead to the inappropriate provision of care and worsening of symptoms. Presently, no research has examined the prevalence of psychiatric boarding in Irish paediatric units. <h3>Methods</h3> We surveyed all Irish paediatric sites regarding this issue. A survey was created using Qualtrics and was composed of three sections; basic demographics, the nature of paediatric boarding admissions and presenting complaints, and finally, questions relating to the clinicians perceived ability to treat psychiatric patients. Paediatricians were contacted from all 20 paediatric sites across Ireland and asked to provide data relating to admission to general wards between the 17th and 23rd of June 2024. <h3>Results</h3> Responses from all sites were gathered. The results indicated that 3.8% (N=37) of all paediatric admissions to general wards in this timeframe were children admitted for psychiatric reasons. All participants reported a rise in the rate of children with mental health difficulties being admitted to general wards in recent years. Despite all doctors stating they have previously managed patients with complex mental health issues, only 15% (N=3) indicated they felt able to provide appropriate care to this cohort. <h3>Conclusions</h3> This study is the first ever attempt to examine the prevalence of psychiatric boarding in Irish paediatric units. The authors intend to replicate this study in several time points in the period of one year to gain a more accurate understanding of the prevalence of this issue and to determine when psychiatric boarding peaks.