Youth who are struggling with self-harm are increasingly forced to visit hospital emergency rooms. The CDC estimated that in 2020, the proportion of emergency room visits by adolescents seeking mental health care increased by 31 percent. Because there are so few spots available in residential psychiatric programs, young patients are left to become “boarders” in emergency departments—kept in small, bare rooms or even in hospital hallways while they wait for an opening. We speak with Dr. Megan Ranney, Academic Dean at the School of Public Health and a Professor of Emergency Medicine at Brown University, about how we got here and what can be done.