There is a significant gap in the healthcare system regarding emergency psychiatric care for patients with severe developmental delays, particularly those who are non-verbal. Individuals with developmental disabilities disproportionately utilize emergency psychiatric services compared to neurotypical peers, yet often experience prolonged boarding in emergency departments (EDs) due to a lack of specialized inpatient resources. One observational study found that children with autism presenting with psychiatric complaints had a median ED length of stay of 3.0 days, compared to 1.2 days for non-psychiatric complaints.
Extended ED boarding delays access to appropriate inpatient care and places patients in environments that are not equipped to meet their complex needs. These conditions increase the risk of adverse events, including self-harm, frequent use of emergency medications, and the use of restraints. General psychiatric units may decline admission due to limited capacity to manage these patients, while specialized Developmental Disability/Mental Illness (DDMI) units often require additional authorization, further delaying care.
As a result, patients may remain in the ED for multiple days or be discharged back to their prior residence while awaiting appropriate placement. This highlights the urgent need for improved systems of care and practical strategies to support this vulnerable population in emergency settings.
This session will address these challenges through case-based discussion of patients with non-verbal autism who experienced barriers to appropriate psychiatric care. Participants will engage in small group discussions to examine the limitations of emergency settings, identify risks associated with prolonged boarding, and explore available resources, including specialized DDMI units. The session will also focus on practical accommodations—such as policy adjustments and environmental modifications—that can be implemented in ED settings to improve safety and quality of care.
Format
Recorded webinar, non-interactive, self-paced distance learning activity.
This presentation was recorded at the 2025 American Psychiatric Association Annual Meeting.
Learning Objectives
- Recognize the gaps in our healthcares system for emergency care for patients with developmental delays
- Discuss the barriers that contribute to patients with developmental delays boarding in the emergency department for multiple days
- Recognize the adverse events that can occur when patients with developmental delays have extended stays in the emergency department
- Identify the specific needs of this population and what resources or accommodations can be provided to these patients in an emergency setting
Target Audience
Medical Students, Residents/Fellows, Psychiatrists
Estimated Time to Complete
Estimated Duration: 1.5 hours
Begin Date: April 1, 2026
End Date: April 1, 2029
How to Earn Credit
Participants who wish to earn 1.5 AMA PRA Category 1 Credit ™ or a certificate of participation may do so by completing all sections of the course including the evaluation. After evaluating the program, course participants will be provided with an opportunity to claim hours of participation and print an official CME certificate (physicians) or certificate of participation (non-physicians) showing the event date and hours earned.
Continuing Education Credit
In support of improving patient care, the American Psychiatric Association is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Physicians
The APA designates this enduring activity for a maximum of 1.5 AMA PRA Category 1 Credit ™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Faculty and Planner Disclosures
The American Psychiatric Association adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Medical Education. Any individuals in a position to control the content of a CME activity — including faculty, planners, reviewers or others — are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.
Program Presenters
- Evelyn Lee, M.D.
- Carolyn Cookson, M.D.
- Katy Lunny, M.D.
- Gail Fernandez, M.D.
- Karen Quan, M.D.
Program Planners
- Vishal Madaan, MD. Chief of Education and Deputy Medical Director, APA.
Accessibility for Participants with Disabilities
The American Psychiatric Association is committed to ensuring accessibility of its website to people with disabilities. If you have trouble accessing any of APA’s online resources, please contact us at 202-559-3900 for assistance.
Technical Requirements
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- The latest and 2nd latest public versions of Google Chrome, Mozilla Firefox, or Safari
- Internet Explorer 11+
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Optimal System Configuration:
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