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Integrated Crisis Care Continuum Expands Access for Youth and Families

Integrated Crisis Care Continuum Expands Access for Youth and Families 1024 683 Lauren Dembeck

Nationwide Children’s comprehensive crisis care continuum connects youth and families with timely, individualized mental health support across hospital, outpatient and community settings.

 

As pediatric mental health needs continue to rise, Nationwide Children’s has developed an integrated crisis care continuum designed to connect children and families with timely services matched to their clinical needs while reducing unnecessary emergency department visits and inpatient hospitalizations.

The model, described in the journal Child and Adolescent Psychiatric Clinics of North America, coordinates five core services: Telecrisis, Mobile Response and Stabilization Services (MRSS), the Critical Assessment and Treatment Clinic (CATC), the Psychiatric Crisis Department, and the Youth Crisis Stabilization Unit.

“The national crisis in youth mental health has not gone away,” says Meredith Chapman, MD, psychiatrist and medical director of the Center for Suicide Prevention and Research at Nationwide Children’s and lead author of the article. “Addressing it requires us to think differently and more holistically about how children and families access care.”

Each service provides a different setting and intensity of intervention. Families can call the 24-hour Youth Psychiatric Crisis Line for immediate assessment, safety planning and guidance. When an in-person response is appropriate, MRSS clinicians can meet families at home, at school or in another community setting, and provide stabilization services for up to six weeks.

The CATC offers rapid outpatient access to psychotherapy, psychiatric evaluation, and medication management. The Psychiatric Crisis Department functions as a dedicated pediatric mental health emergency department, while the Youth Crisis Stabilization Unit provides brief, individualized and family-centered treatment as an alternative to traditional inpatient psychiatric hospitalization.

“We cannot respond to every young person in crisis by hospitalizing them,” says David Axelson, MD, chief of the Department of Psychiatry and Behavioral Health at Nationwide Children’s and senior author of the article. “We need to assess each child’s and family’s needs and provide care in the setting and at the intensity most likely to support sustained improvement.”

The programs function as an interconnected system, allowing clinicians to coordinate transitions as a child’s needs change. A family may initially contact Telecrisis, receive an assessment in the community through MRSS, and then transition to rapid outpatient treatment through CATC. Alternatively, a child requiring more intensive evaluation or stabilization can be directed to the Psychiatric Crisis Department or Youth Crisis Stabilization Unit.

This coordination has coincided with substantial reductions in psychiatric boarding, defined as the time medically cleared patients remain in hospital beds while awaiting psychiatric admission. Boarder patient days at Nationwide Children’s declined from 4,238 in 2021 to 694 in 2025. Since 2020, four of the crisis programs have collectively served more than 30,000 patients through approximately 109,000 visits.

“When children receive services that are appropriately matched to their needs, they are less likely to spend unnecessary time waiting in the hospital,” says Dr. Chapman. “Having multiple coordinated options allows us to improve access while maintaining safety and continuity of care.”

The team continues to evaluate Psychiatric Crisis Department revisits and strengthen follow-up within seven days of emergency mental health care, particularly for youth with suicidal thoughts or behaviors. They also emphasized that the continuum depends on multidisciplinary collaboration among hospital clinicians, primary care practices, schools, community agencies, and first responders.

“This continuum represents the work of a tremendous group of people across many disciplines,” says Dr. Axelson. “Its strength comes from teams across the hospital and community working together to help children and families remain connected to care as their needs change.”

 

Reference

Chapman MR, Glawe CJ, Moore A, Axelson DA. Continuum of Crisis Care. Child and Adolescent Psychiatric Clinics of North America. 2026 Jul;35(3):439-452. doi: 10.1016/j.chc.2026.03.003. Epub 2026 May 6.

 

About the author

Lauren Dembeck, PhD, is a freelance science and medical writer based in New York City. She completed her BS in biology and BA in foreign languages at West Virginia University. Dr. Dembeck studied the genetic basis of natural variation in complex traits for her doctorate in genetics at North Carolina State University. She then conducted postdoctoral research on the formation and regulation of neuronal circuits at the Okinawa Institute of Science and Technology in Japan.

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