6.24 Characteristics of Children, Adolescents, and Young Adults With Neurodevelopmental Disorders Who Are Presenting to Psychiatric Emergency Services

There is very little information about patients with neurodevelopmental delays (NDD), including ASD, who present to psychiatric emergency services in a state of crisis. Given this backdrop, this study aims to explore clinical and demographic information about this patient group over a 9-year period who had presented at a Midwestern academic medical center. Participants’visits included (n = 1461) individuals with NDD/ASD who ranged in age from 0 to 26 years and had presented to a psychiatric emergency department between 2012 and 2021. After obtaining approval of the IRB, coded data were extracted using a structured chart review methodology. Data included demographic and clinical variables. Descriptive analyses were performed. Patients were predominantly adolescent males (73%; mean age ± SD = 15.5 ± 4.3). The most common reason for their presentation was aggression toward others (53%) and/or self-injurious behaviors (25 %). A minority had received psychological treatment such as applied behavior analysis (8%), although many (48%) had a history of receiving inpatient psychiatric care. Most of the patients were already receiving a psychotropic medication (81%; already receiving an antipsychotic agent = 51%, followed by those on antidepressants = 37%). During their emergency visit, 24% were prescribed a new psychotropic agent (addition of an antipsychotic, followed by a benzodiazepine, in order of frequency); almost a third (28%) were referred for a psychiatric hospitalization, while the majority (54%) were deemed suitable for return to their home, and a significant number (12%) could not be hospitalized, despite the recommendation, due to the lack of an inpatient bed or a facility. Additional analyses will be presented to identify trends over time and patterns of dispositions. This study focuses on a group of highly acute individuals who place considerable demand on already-stretched psychiatric emergency services. Findings underscore the infrequent use of and possible difficulty accessing behavior therapy, frequent reliance on antipsychotic agents, and a lack of resources for hospitalization. These areas of concern require further investigation and systematic service planning across multiple levels.