Evolution of the Youth Crisis Stabilization Unit

Evolution of the Youth Crisis Stabilization Unit 1024 538 Mary Bates, PhD

An alternative to inpatient hospitalization for youth experiencing a mental health crisis and their families sees success at Nationwide Children’s.


The Youth Crisis Stabilization Unit (YCSU) is an inpatient psychiatric setting at Nationwide Children’s for children and adolescents experiencing a mental health crisis. Over the last 12 years, the YCSU has grown from a two-bed unit housed within a general emergency department to a 16-bed unit designed specifically with the needs of youths and families in crisis in mind. In a new book chapter, clinicians and researchers from Nationwide Children’s detail why the unit was established, how it has grown and why it is a promising alternative psychiatric intervention to traditional inpatient hospitalization.

In recent years, the availability of inpatient psychiatric beds for adolescents has declined. At the same time, suicidal behaviors and self-injury among youth have increased. The YCSU was developed to help meet the growing mental health needs of children and adolescents in the central Ohio region.

“We were finding that the existing structure that insurance companies and hospitals in our community were using was not really conducive to what families needed,” says Mary Fristad, PhD, a clinical child and adolescent psychologist at Nationwide Children’s and senior author of the new chapter. “So we worked to get hospital systems, community partners and insurance companies to cooperate in a structure that is functional for families.”

The YCSU began in 2010, supported by a grant from the county Alcohol, Drug, and Mental Health (ADAMH) Board. The success of the program in these initial years led to further funding and growth of the YCSU.

In 2020, Nationwide Children’s opened the Big Lots Behavioral Health Pavilion and the YCSU moved to this new facility, expanding its size to 16 beds. The new unit was designed with safety concerns in mind. Presently, the treatment team includes child and adolescent psychiatrists, nurses, clinical therapists, mental health specialists, and recreational therapists.

“It has evolved into a compact program where every day is filled to the brim with therapy,” says Dr. Fristad. “Since the length of stay is shorter—three to four days, on average—the actual total cost is less than the typical inpatient hospitalization.”

“The biggest philosophical difference compared to a traditional inpatient unit is the exclusive focus on the individual, their family and the crisis that brought them to the unit,” says Joyce Chen, MD, a child and adolescent psychiatrist at Nationwide Children’s and lead author of the chapter. “The goal is to help the patient and their family build communication and coping skills that will help them manage outside of the unit.”

“The YCSU continues to grow and evolve, which is a testament to our community appreciating and valuing it,” says Dr. Chen, who is also an assistant professor of clinical psychiatry at The Ohio State University College of Medicine.

“This model is a great example of family- centered psychiatric care.  We not only treat patients individually, but work their families to make positive and hopefully, lasting impact.  We hope that by sharing how the YCSU began and developed into what it is today, we can inspire others and be a resource for institutions who are interested in providing care for similar populations.”




Chen, J.T., Bruns, E., Schellhause, Z., Garcia, C., Fristad, M.A. (2022). The Youth Crisis Stabilization Unit: An Alternative Psychiatric Treatment Model. In: Leffler, J.M., Frazier, E.A. (eds) Handbook of Evidence-Based Day Treatment Programs for Children and Adolescents. Issues in Clinical Child Psychology. Springer, Cham. https://doi.org/10.1007/978-3-031-14567-4_25.

Image credit: Nationwide Children’s




About the author

Mary a freelance science writer and blogger based in Boston. Her favorite topics include biology, psychology, neuroscience, ecology, and animal behavior. She has a BA in Biology-Psychology with a minor in English from Skidmore College in Saratoga Springs, NY, and a PhD from Brown University, where she researched bat echolocation and bullfrog chorusing.