An Outcome Evaluation of an Inpatient Crisis Stabilization and Assessment Program for Youth

Abstract

Objective: To describe characteristics and outcomes of youth aged 7 to 17 who received inpatient psychiatric and mental health services along different clinical pathways of a new service delivery model. Method: Participants included 211 admissions to an inpatient crisis stabilization and assessment program over a one-year period. Standardized measures of emotional and behavioral functioning were administered as part of routine patient care. Results: Data from multiple sources indicate that youth presented with an appropriately acute and complex level of risk, with predominantly internalizing symptoms. Unique profiles of needs were identified according to services received. Length of stay was consistent with the model of care and differed for youth receiving only crisis (4 days) versus crisis plus assessment services (13 days).transitional care had longer length of stay for crisis/assessment services (19 days). Outcome data indicated a significant reduction in risk acuity at discharge or transfer for most youth; those referred to transitional care continued to have significant internalizing symptoms, including suicide risk. Conclusions: Evaluation data inform daily clinical practice, are consistent with the model of care, and provide an evidence-based approach to inpatient psychiatric services that allows for ongoing assessment of the quality of these services provided to youth and their families.

Evaluating effectiveness in adolescent mental health inpatient units: A systematic review

“…During treatment included 4 weeks after admission (Green et al . ), 14 days after admission (Greenham & Bisnaire ), and the remaining study did not indicate the time points (Herdzik ).…”

“…However, regardless of LOS, changes in symptom severity were found from admission to the follow-up time point for a number of studies. For instance, despite a short LOS of 4 or 6 days, clients improved (Barnes 2009;Greenham & Bisnaire 2008). Guvenir et al (2009) each outcome measurement assessment in mental health is an intervention in itself.…”

“…Three studies examined some outcomes at admission, during treatment and discharge. During treatment included 4 weeks after admission (Green et al 2007), 14 days after admission (Greenham & Bisnaire 2008), and the remaining study did not indicate the time points (Herdzik 2009).…”

Assessing the relationship between therapeutic goal attainment and psychosocial characteristics for adolescents in crisis residence

“…), the elements of problem identification, processing coping skills, and commitment to follow-up were shared with the goal attainment model (Balkin, 2003;Balkin & Roland, 2005, 2007. Greenham and Bisnaire (2008) emphasized the need for crisis stabilization in a safe environment, family involvement, and goal-directed interventions in addressing the needs of children and adolescents admitted to a crisis stabilization program. Greenham and Bisnaire's model was effective in reducing acute symptoms for children and adolescents in acute care psychiatric hospitalization.…”

“…Greenham and Bisnaire's model was effective in reducing acute symptoms for children and adolescents in acute care psychiatric hospitalization. Similar to Greenham and Bisnaire (2008), Regan et al (2006) emphasized problem solving and family involvement but further elaborated the role of the family by making family involvement the central focus of the intervention. Regan et al used a child and family centered care model by addressing problem solving strategies in the context of collaborating with both the patient and parent(s)/guardian(s).…”