Date of Award


Document Type



College of Nursing

Degree Name

Doctor of Nursing Practice (DNP)

Project Mentor

Elizabeth Gabzdyl


Amanda Heffernan


Objective: To advocate for better mental health coverage for adolescent youth, the goal of this DNP project was to identify disparities across levels of care based on insurance type to propose a solution that improves accessibility to appropriate levels of care for all adolescents.

Design: This is a patient advocacy project that utilized a retrospective chart review.

Setting: The setting for this project was a 27-bed hospital-based adolescent behavioral health unit in a hospital in Tacoma, WA.

Participants: Participants included 875 patients admitted to the unit between April 2020 and April 2021. Methods: Patient charts from the desired time frame were manually reviewed and pertinent data was extracted. Descriptive statistics were used to capture the metric data.

Results: The average length of stay was slightly higher for patients with Medicaid compared to private insurance. Most patients were admitted for a diagnosis of major depressive disorder, typically only had one hospitalization prior to admission to the ABHU, were set up with outpatient services upon discharge, and had zero readmissions following discharge. There was a statistically significant association found between services set up for discharge and insurance type, as well as between services utilized prior to admission and insurance type.

Conclusion: This study did find gaps in levels of care based on insurance type. There is much work to be done to help improve the accessibility to appropriate services for adolescent psychiatric care and the results of this study are helpful in understanding the gaps that need to be filled.