Debate: Putting psychiatric hospitalization for children and adolescents in its place: it is time to create a system of care that works.

Inpatient psychiatric care is the most expensive resource within the pediatric mental health system and is too often justified based on the lack of more appropriate and effective services. Rates of readmission are high, and data regarding long-term benefits are lacking. The continuum of care needs to be realigned to meet the needs of children and families, with investments in intensive community-based services and evidence-based training while limiting the use of acute inpatient care to those patients whose clinical presentations require and benefit from that level of service.