The Emergency Department (ED) is an overwhelming place for many children, families, and caretakers as they navigate the challenges of accessing psychiatric care. This situation has been exacerbated with the strains put on the behavioral health system by the COVID–19 pandemic. The number of youths awaiting placement has increased dramatically and the number of days these youths remain in EDs awaiting inpatient psychiatric beds or other services has also increased. It is not uncommon to have youth waiting two weeks or more for a placement. The following is a resource guide of best practices that organizations can implement when working with pediatric patients and their families or caretakers during psychiatric boarding in the ED. This guide was prepared by participating Massachusetts Health & Hospital Association (MHA) members and the Parent and Professional Advocacy League (PPAL).