Thomas Lynelle E
Yale University School of Medicine, Child Study Center, 230 South Frontage Road, Post Office Box 207900, New Haven, CT 06520-7900, USA.
Child Adolesc Psychiatr Clin N Am. 2003 Oct;12(4):599-611. doi: 10.1016/s1056-4993(03)00054-3.
Ultimately, decreased hospital lengths of stay, endemic shortages of psychiatric hospital beds, lengthy waits for indicated outpatient services, and closing of residential treatment facilities, safe homes, and detention centers have led to what could be viewed as a children's mental health service "de-institutionalization." Only critical shifts in the underlying philosophy, practice, financing, and perceived role of hospital-based child and adolescent psychiatric emergency service will put the pediatric emergency department in a position to keep up with the accelerating service demands.
最终，住院时间的缩短、精神病医院床位的长期短缺、等待指定门诊服务的漫长时间，以及住院治疗设施、安全之家和拘留中心的关闭，导致了可被视为儿童心理健康服务的“去机构化”。只有医院儿童和青少年精神科急诊服务在基本理念、实践、融资和认知角色上发生重大转变，儿科急诊科才能跟上加速增长的服务需求。
