If your child’s mental health symptoms are mild to moderate, outpatient pediatric psychiatric care may be the best option. However, inpatient care may be appropriate for kids with severe symptoms of psychiatric illness. Examples include depression that affects their ability to attend school or violent behavior that puts them or others in danger.

Signs that inpatient mental health care may be beneficial for your child or teen include: 

• Hurting themselves (self-harm) or others (including siblings and parents)
• Preoccupation with suicide or death
• Risky or violent behavior (e.g., playing with knives, starting fires)
• Severe anxiety or depression
• Severe sleep disturbances
• Withdrawing from school or other activities
• Other drastic behavior changes

If your child is in immediate danger, go to the emergency department. You can also reach out to your child’s primary care provider or our pediatric psychiatry team directly. Inpatient care is not the first line of treatment and is only used in extreme cases as determined by your child’s care team.

To determine if inpatient care is appropriate, our team will first evaluate your child’s mental state with you present, then interview them one-on-one. We may also recommend keeping them overnight for observation before determining whether to admit them.

As part of our evaluation, we may consult with your child’s other providers, schools and counselors. Our aim is to support your child in the least restrictive environment while prioritizing their mental health care and well-being.

Your child’s care team will be led by an attending physician who is a child and adolescent psychiatrist. Other members of the team include:

• A full-time, specialized teacher, who can work with your child’s school on recommendations, follow any individualized education program (IEP) your child has and make referrals if necessary. Our on-site teacher can also help your child complete their assignments so they don’t miss any schooling.
• Board certified analysts, who develop personalized behavior support plans using applied behavior analysis.
• Mental health technicians (MHTs), who support the patient during their stay.
• Milieu therapists, who lead activities to create a healing environment on the unit.
• Psychiatric nurses, who specialize in supporting kids.
• Recreational and occupational therapists, who lead group therapy and help kids develop coping skills.
• Resident physicians, who are doctors in advanced training who work closely with attending physicians to provide your child’s daily care and treatment.
• Social workers, who help manage mental health and emotional challenges by providing counseling, crisis support, and connecting patients with community and healthcare resources to promote stability and well-being.

All team members are trained to care for children and teens during a mental health crisis. We can also provide guidance and parent resources to help you support your child during and after their hospitalization. 

The length of your child’s stay will depend on their situation, but most patients stay for about five days. During this time, older kids and teens can make phone calls on the unit, but cell phones will be stored away until discharge. 

Visitation rules for inpatient psychiatric stays are as follows:

• Visits must be scheduled in advance by calling (573) 884-1255.
• Visiting hours are 4 p.m. to 8 p.m. daily.
• Patients may have two visitors over age 18 at a time.
• Visitors must be a parent, guardian or grandparent. Other visitors must be approved by a parent or guardian.
• All visitors must be listed as a contact in the patient’s electronic medical record.
• Children younger than 18 are not allowed to visit and may not be left unattended in the waiting room or other areas of the hospital.