Digital Media and Device-Related Conflicts During Pediatric Mental Health Boarding

OBJECTIVES: Prolonged mental health boarding can create conflict between pediatric patients reliant on digital devices to manage psychiatric distress and clinical teams seeking to enforce safe digital media/device habits. This study aimed to estimate the frequency of these conflicts and the characteristics of patients who may be most impacted by restrictions on digital media/device use while boarding. METHODS: Electronic medical records were reviewed for youth aged 6 to 17 years old. who presented in psychiatric crisis to a US metropolitan hospital in 2021 or 2022; all patient encounters involving mental health (MH) boarding were identified. Collected information included patient age, sex, and psychiatric diagnoses. Each encounter was reviewed as to whether it included conflict(s) related to patient digital media/device use, coded under 6 distinct categories (eg, behavioral dysregulation related to restrictions on device access). Relationships between variables of interest were assessed using t tests and logistic regression models. RESULTS: There were 2327 boarding encounters during the reviewed time period, representing 1869 unique patients. Approximately 10% of patients experienced a problem related to their use of digital media or electronic devices. Younger, male patients and those with diagnoses of autism spectrum disorder and attention deficit hyperactivity disorder were significantly more likely to have had a digital media/device-related conflict documented during MH boarding. CONCLUSION: Proactive interventions should be considered to address problematic separation from digital media/devices during pediatric MH boarding, particularly in younger, male patients.