Children's Hospital Colorado

Levels of Psychiatric Acute Care for Pediatric Patients

Addressing the unique needs of every child so they can be their unique selves.

When kids and adolescents experience a mental health crisis or other serious mental health issue, they often need coordinated, intensive care. It’s helpful to be familiar with the different types of effective acute mental health care available for youth.  

Comprehensive mental health care at Children’s Colorado

Higher-level, acute or intensive mental health care focuses on crisis stabilization, assessment, safety monitoring and ongoing treatment planning. Determining the appropriate programming for pediatric patients is a collaborative process between the patient, family, and interdisciplinary treatment team. Providers should consider many factors when determining the right type of care including severity and duration of symptoms, functional impairment and patient safety. This article outlines programs for patients and families who need higher-level pediatric mental health care.

Inpatient psychiatric units

Inpatient psychiatric units are designed to address immediate risk, start treatment and support youth and families in accessing ongoing care after they leave. Psychiatric hospitalization involves 24/7 interdisciplinary care that typically lasts from 3 to 10 days based on individual patient needs. It’s intended for patients who present an immediate risk toward themselves or others.

Children’s Hospital Colorado’s inpatient psychiatric care treats patients ages 5 through 18 presenting with a mental health crisis. Our care takes place in the Emergency Department or by the inpatient psychiatry consultation and liaison team. Youth receive a thorough psychiatric evaluation and ongoing interdisciplinary treatment from a team that includes a psychiatric provider, psychologist, master’s level therapists, nurses, and mental health support staff. Our primary treatment method is group therapy, using an evidence-based model that supports youth in learning effective behavioral and cognitive strategies to manage strong emotions. Additionally, patients participate in individual and family therapy, creative arts therapy, and occupational therapy groups.

Neuropsychiatric Special Care Inpatient Program

The Neuropsychiatric Special Care (NSC) Inpatient Program at Children’s Colorado provides interdisciplinary treatment to children age 4 to 17 with an intellectual or developmental difference who are experiencing a behavioral or mental health crisis. Treatment focuses on reducing behaviors that may present a risk of harm to the patient or others (e.g., aggression, self-injury, property destruction). The NSC Inpatient Program provides 24-hour care with an average admission length of 5 to 7 days. An interdisciplinary team of mental health professionals provide care including a psychiatrist, psychologist or board-certified behavior analyst, behavioral health clinician, pediatric nurses, occupational therapists, creative arts therapists and behavioral health specialists. Care includes group and individual therapies and medication management. The primary therapy modality is applied behavior analysis with cognitive behavior therapy, based on a child’s needs.

Partial hospitalization programs

These programs, also called day treatment programs, provide intensive mental health treatment to youth experiencing serious emotional or behavioral difficulties that are negatively impacting their ability to function at home, school or in the community. Patients may present ongoing risk towards themselves or others but are able to maintain safety without 24-hour supervision.

Partial hospitalization programs can be used as either a step-down from inpatient psychiatric care or as a stand-alone level of care to stabilize worsening mental health concerns and prevent hospitalization. Patients attend treatment for six or more hours a day, every day or most days of the week. These programs may specialize in a specific problem area or cover a broader scope of psychiatric concerns. Services provided in partial hospitalization programs often include psychiatric evaluation, individual and group therapy, nursing support, medication management, education services, and family education and support.

Children’s Colorado’s Partial Hospitalization Program provides comprehensive, interdisciplinary treatment for children and adolescents with a wide range of significant mental health difficulties, such as suicidal thoughts or behaviors, non-suicidal self-injury, anxiety, depression, and defiant or aggressive behaviors. These challenges make it difficult for the youth to fully participate in home, school or community activities.

Treatment goals primarily focus on increasing day-to-day functioning, stabilizing safety related concerns and building skills to support youth and their families with building distress tolerance. Our evidence-based treatment model supports youth and families in learning effective behavioral and cognitive strategies for managing strong emotions and behaviors. Specifically, partial hospitalization program classroom skills curriculums are based on the Unified Protocol for Emotional Disorders, which allows children to focus on a straightforward goal. Patients receive a psychiatric evaluation, group and individual therapy, medication management, creative arts therapy and educational services. As a family-centered program, we know caregiver participation is critical and will improve the overall outcomes for our patients. Caregivers are required to attend daily check-in groups, psychoeducation groups and family therapy/caregiver meetings. The program runs Monday through Friday at Anschutz Medical Campus, North Campus and Therapy Care at Telstar, Colorado Springs locations. The average length of partial hospitalization program admission is 12 program days.

Each of these locations treats a different age range. Please contact the location for more information.

Neuropsychiatric Special Care (NSC) Partial Hospitalization Program

Much like our inpatient program, our NSC Partial Hospitalization Program cares for kids age 4 to 17 with an intellectual or developmental difference who are experiencing a behavioral or mental health crisis. Our providers help reduce potentially harmful behaviors for the patient or others (e.g., aggression, self-injury, property destruction, etc.). Patients attend the NSC partial hospitalization program for several hours during the day, Monday through Friday, with average admission lasting 10 to 12 days. Children receive care from mental health professionals including psychiatrists, psychologists or board certified behavior analysts, behavioral health clinicians, nurses, occupational therapists, creative arts therapists and behavioral health specialists. Treatment includes group and individual therapies, as well as medication management. The primary therapy modality is applied behavior analysis with cognitive behavior therapy, as needed.

Eating Disorders Program

The Eating Disorders Treatment Program at Children’s Colorado provides family-based treatment to patients age 8 to 17 presenting with a primary eating disorder (e.g. anorexia nervosa, bulimia nervosa, avoidant/restrictive food intake disorder, other specified feeding or eating disorder). The focus of treatment is on nutritional stabilization and providing caregivers with the skills they need to effectively feed their child at home. The Eating Disorders Program primarily utilizes family-based treatment with a strong focus on parent supported nutrition. Patients also receive individual and group therapy focused on skills from the Unified Protocol for Emotional Disorders to address eating disorder symptoms and common comorbidities (e.g. anxiety, depression, trauma).

Our Program provides care 7 days a week. The average length of stay is 5 to 7 weeks, although this varies based on individual needs and treatment goals. Our interdisciplinary team of mental health professionals provides treatment including psychiatrists, advanced practice nurses, therapists, psychologists, social workers, dietitians, nurses and behavioral health specialists. Treatment includes family therapy, group therapy (parent, child and multi-family), individual therapy, medication management, meal coaching and medical monitoring.

Intensive outpatient programs

Intensive outpatient programs are more intensive than routine outpatient care, providing a minimum of three hours of treatment per day, two to five days per week. Intensive outpatient programs primarily use a group format and are intended for individuals who require multi-modal treatment that can’t be provided in a traditional outpatient setting. Services may include group, individual and family psychotherapy, as well as psychoeducational activities. This level of mental health treatment is appropriate for youth with mental health concerns significant enough to disrupt day-to-day living, but who can still safely live at home and go to school.

Intensive outpatient pediatric programs for anxiety

Children’s Colorado offers two six-week, evidence-based, intensive outpatient programs. One is for children (8 to 12) and is for teens (13 to 17) experiencing high levels of impairment due to anxiety or obsessive-compulsive disorder. Typically, patients in our programs have tried individual therapy and have not experienced lasting benefits and may have tried anti-anxiety medication. Youth experiencing primarily post-traumatic anxiety are typically not appropriate for the anxiety outpatient programs due to the unique needs of such patients. Additionally, while school refusal or avoidance is a common behavior for youth presenting with highly impairing anxiety, children and teens who experience school refusal for reasons other than anxiety or obsessive compulsive disorder (e.g., due to mood disturbance or bullying) are not likely to benefit from our programs.

The teen anxiety outpatient program meets three days a week at Children’s Hospital Colorado on Anschutz Medical Campus in Aurora. The program features evidence-based interventions, including exposure with response prevention, acceptance and mindfulness-based strategies and interventions geared toward reducing accommodation of anxiety at home. Some sessions include adolescent- and parent-focused group therapy and other sessions feature adolescent group therapy as well as individual family sessions occurring every other week. Parent involvement in the adolescent intensive outpatient program is critical. The program works on a rolling admission, so new families may enter the program each week. As part of this program, we strongly encourage each child to complete a medication consultation session with one of our psychiatrists.

The child anxiety outpatient program at Therapy Care, Highlands Ranch meets three days a week. The program works on a semi-rolling admission, so new families may enter the program every three weeks. We strongly encourage children and caregivers to attend all sessions over the six-week period. An interdisciplinary team of mental health professionals provide care including psychologists, licensed behavioral health clinicians and trainees in psychology and related disciplines. We also offer opportunities for medication consultation. The program features evidence-based interventions, including exposure with response prevention, cognitive behavioral therapy and interventions geared toward reducing accommodation of anxiety at home. All three days require caregiver involvement for caregiver-focused group therapy as well as caregiver-supported child group therapy. Caregivers will learn evidence-based strategies to respond effectively to their children’s anxious behaviors by encouraging bravery and supporting the use of coping skills, and to reduce their own behaviors that may serve to maintain anxiety.

Continuity of care

Supporting patient transitions across levels of care is critical.  The first few months after discharge from an intensive mental health program, particularly for those admitted due to suicidal ideation or behaviors, is a time of increased risk. Establishing appropriate follow-up care within seven days following an inpatient psychiatric admission can help reduce this risk, significantly lowering the odds of patient suicide. Our team is committed to ensuring all youth are connected to ongoing mental health supports following discharge from our high-level treatment programs.

COVID-19 impact on pediatric mental health

Unfortunately, the COVID-19 pandemic resulted in a devastating impact to the emotional well-being of our youth. Rates of anxiety, depression and suicidality have doubled since 2020. Estimates suggest that at least 1 in 5 youth are now experiencing a mental health disorder and suicide has become a leading cause of death for youth age 10 to 24. It’s important to acknowledge that certain subpopulations of youth are being disproportionately negatively impacted by the mental health crisis, particularly since the onset of the pandemic. Most notably, girls, racial and ethnic minorities and LGBTQ+-identifying youth are demonstrating the most alarming mental health trends, with significant prevalence increases in rates of suicidality, as well as emotional and behavioral concerns.

Mental health resources

Children’s Hospital Colorado Resources:

Community Resources: