Interest in the development of pediatric medical-psychiatric units con
tinues to grow, driven be clinical, financial, and interdisciplinary c
onsiderations. While virtually all of the pediatric medical-psychiatri
c units reported in the literature to date have arisen in the pediatri
c setting, there are considerations that may encourage the development
of such programs in the psychiatric setting. The authors report on th
e development and characteristics of a pediatric medical-psychiatric s
pecialty inpatient unit developed in a psychiatric hospital. Advantage
s and disadvantages of the psychiatric hospital setting are considered
in light of cumulative experience.