Last spring, a 15-year-old girl was rushed by her parents to the emergency department at Boston Children’s Hospital. She had marks on both wrists from a recent suicide attempt. Earlier that day she confided to her pediatrician that she planned to try again.

In the ER, a doctor examined her and explained to her parents that she was not safe to go home. The doctor added, “But I need to be honest with you about what’s likely to unfold. The best place for adolescents in distress is not a hospital but an inpatient treatment center. But there are no openings in any of the treatment centers in the region.”

Indeed, 15 other adolescents—all in precarious mental condition—were already housed in the hospital’s emergency department. They were sleeping in exam rooms night after night, waiting for an opening. The average wait for a spot in a treatment program was 10 days.

Mental health disorders are surging among adolescents: In 2019, 13 percent of adolescents reported having a major depressive episode, a 60 percent increase from 2007. Suicide rates, stable from 2000 to 2007, leaped nearly 60 percent by 2018, according to the CDC.

Without the inpatient option, emergency rooms have taken up the slack. A recent study of 88 pediatric hospitals around the US found that 87 of them regularly board children and adolescents overnight in the ER. On average, any given hospital saw four boarders per day, with an average stay of 48 hours.

Dr. JoAnna Leyenaar said, “There is a pediatric pandemic of mental health boarding.” She extrapolated from data to estimate that at least 1,000 young people, and perhaps as many as 5,000, board each night in the nation’s 4,000 emergency departments. “We have a national crisis.”