ABSTRACT

The history of child and adolescent mental and behavioral care in the United States is loosely linked to the evolution of professional psychiatric organizations. Child psychiatry originated with pediatric guidance clinics in the 1920s in response to juvenile delinquency. A review of the data associated with pediatric mental and behavioral health patients is useful in the development of needs assessments for this population and the related facility requirements. Three important factors contribute to the description of a residential healthcare setting: average length of stay, average daily census, and number of beds. Regarding outpatient design goals, A. F. Garland pointed out the alarming levels of fragmentation and ineffectiveness of community-based outpatient mental health clinics in the treatment of children. J. Piaget modeled children's development on the notion of "increasingly powerful logico-mathematical structures," while a more contemporary approach addresses "conceptual knowledge structures" and may be linked to their social environmental circumstances.