Hospital-to-Community Transitions: A Bridge Program for Adolescent Mental Health Patients

Cameron, Christopher L.; Birnie, Kathryn A.; Dharma-Wardene, Melina W.; Raivio, Elaine; Marriott, Brian

doi:10.3928/02793695-20071001-09

Cited by 8 publications

(12 citation statements)

References 9 publications

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“…Other studies that implemented transitional interventions with a focus on therapeutic relationships have also shown promising results (Cameron et al . 2007, Orlosky et al .…”

Section: Introductionmentioning

confidence: 99%

Integrating an evidence‐based intervention into clinical practice: ‘transitional relationship model’

Forchuk¹,

Martin²,

Jensen³

et al. 2012

Psychiatric Ment Health Nurs

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Accessible summary The transitional relationship model (TRM) facilitates the discharge of psychiatric clients from hospital to community by providing hospital staff involvement until a therapeutic relationship has been established with a community care provider as well as peer support. Psychiatric wards at six hospital sites implemented the TRM in three waves. Monthly summaries, progress reports, meeting minutes and focus group discussions were reviewed in order to uncover facilitators and barriers to TRM implementation. Factors that facilitated TRM implementation included: educational modules for staff and peer training, the presence of on‐site champions, and supportive documentation systems. Barriers included: feeling swamped/overwhelmed, death by process, team dynamics and changes in champions. Implementation strategies suggested by the initial hospital wards were used to enhance implementation on subsequent wards, leading to positive outcomes. This study highlights the need to address work environment issues when implementing healthcare interventions, particularly for interprofessional teams. Abstract The transitional relationship model (TRM) facilitates the discharge process by providing peer support and hospital staff involvement until a therapeutic relationship has been established with a community care provider. A quasi‐experimental, action‐oriented research design was employed in which psychiatric wards at six hospital sites implemented the model in three waves. Helpful strategies were identified by each wave of wards for consideration by subsequent wards. Using an ethnographic approach, qualitative data were examined to uncover experiences and perceptions of TRM implementation and to help identify key issues that were supporting or hampering implementation. Specific strategies that facilitate the implementation of TRM include: (1) the use of educational modules for on‐ward hospital staff training and peer training; (2) presence of on‐site champions; and (3) supportive documentation systems. Issues identified as barriers to implementation included: (1) feeling drowned, swamped and overwhelmed; (2) death by process; (3) team dynamics; and (4) changes in champions. Staged large‐scale implementation of the TRM allowed for iterative improvements to the model leading to positive outcomes. This study highlights the need to address work environment issues, particularly interprofessional teams.

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“…Other studies that implemented transitional interventions with a focus on therapeutic relationships have also shown promising results (Cameron et al . 2007, Orlosky et al .…”

Section: Introductionmentioning

confidence: 99%

Integrating an evidence‐based intervention into clinical practice: ‘transitional relationship model’

Forchuk¹,

Martin²,

Jensen³

et al. 2012

Psychiatric Ment Health Nurs

View full text Add to dashboard Cite

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“…Discharge interventions reported in the reviewed literature were varied in structure, owing to a lack of standardization of the terms "discharge intervention" and the diversity in settings and populations across projects. Most discharge interventions (n = 9) were structured as a standalone program [47][48][49][50][51][52][53][54]. These programs were longitudinal, multicomponent, and often featured a multidisciplinary team that was responsible for supporting patient discharge.…”

Section: Discharge Intervention Structuresmentioning

confidence: 99%

“…These programs were longitudinal, multicomponent, and often featured a multidisciplinary team that was responsible for supporting patient discharge. Four programs described bridging aspects with case management, clinical services, discharge planning and referrals to outpatient community resources to maintain continuity of care for the patient [47][48][49][50]. Two programs supporting patients in maintaining clinical stability, improving family functioning, and building vocational and social skills through therapy and counselling [51,52].…”

Section: Discharge Intervention Structuresmentioning

confidence: 99%

“…Many authors (n = 5) discussed the task of case management in tailoring treatment and discharge plan to the patients' needs [50,[58][59][60]65]. Interventions included personalized goal-setting tools and identifying barriers to services that would allow the healthcare team to then determine safety plans [64], work with them toward identified goals [54], or possible solutions in the discharge plan [47,48,58].…”

Section: Individualized Carementioning

confidence: 99%

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Discharge interventions from inpatient child and adolescent mental health care: a scoping review

Chen

Dinyarian

Inglis

et al. 2020

Eur Child Adolesc Psychiatry

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The post-discharge period is an extremely vulnerable period for patients, particularly for those discharged from inpatient children and adolescent mental health services (CAMHS). Poor discharge practices and discontinuity of care can put children and youth at heightened risk for readmission, among other adverse outcomes. However, there is limited understanding of the structure and effectiveness of interventions to facilitate discharges from CAMHS. As such, a scoping review was conducted to identify the literature on discharge interventions. This scoping review aimed to describe key components, designs, and outcomes of existing discharge interventions from CAMHS. Nineteen documents were included in the final review. Discharge interventions were extracted and summarized for pre-discharge, post-discharge, and bridging elements. Results of this scoping review found that intervention elements included aspects of risk assessment, individualized care, discharge preparation, community linkage, psychoeducation, and follow-up support. Reported outcomes of discharge interventions were also extracted and included positive patient and caregiver satisfaction, improved patient health outcomes, and increased cost effectiveness. Literature on discharge interventions from inpatient CAMHS, while variable in structure, consistently underscore the role of such interventions in minimizing patient and family vulnerability post-discharge. However, findings are limited by inadequate reporting and heterogeneity across studies. There is a need for further research into the design, implementation, and evaluation of interventions to support successful discharges from inpatient child and adolescent mental health care.

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“…Therapeutic support should enhance the "continuity of care" (Cameron, Birnie, Dharma-Wardene, Raivio, & Marriott, 2007, p. 25), thereby playing a key role within the health care of teens. While Cameron et al (2007) conducted their research at a residential treatment facility that served adolescents as they returned from the hospital; their focus was on parents' and staff's qualitative and quantitative account of needs. This focus did offer insight into the needs of this population during the time of post-hospitalization, but it still did not offer adolescents a voice, and it did not address the needs of teens returning directly to their former school.…”

Section: Study Contextualization: Why Mental Health In Schools?mentioning

confidence: 99%

Getting back to school : understanding adolescents' experience of reentry into school after psychiatric hospitalization

Simone¹

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The purpose of this qualitative study was to explore the experience students have reentering high school following psychiatric hospitalization, and within programming designed to assist with this transition. To accomplish this goal, two research questions were formulated to guide this study:What is the experience of re-entering high school, for adolescents, after a psychiatric hospitalization? and How does the transition programming work with students reentering the high school after hospitalization, considering the bridge for resilient youth in transition model milieu program as a Community of Practice? Participants were chosen from suburban high schools that offer the bridge for resilient youth in transition model programming. Data were collected from eight participants through a series of semi-structured, in-depth interviews. Data were analyzed using general inductive analysis, and was coded using multiple strategies, including open and axial coding. Three conclusions derived from the findings of this research.First, reentering high school after psychiatric hospitalization is an experience that produces academic and social stressors for students as they continue to manage symptoms. Second, BRYT reentry programming helps to support academic recovery, and mental health recovery, through relationship development and connectedness at school. Finally, BRYT reentry programs exist as Communities of Practice, where students' identities and their shared endeavor of reentry after psychiatric hospitalization are improved via meaningful engagement in the milieu.

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Hospital-to-Community Transitions: A Bridge Program for Adolescent Mental Health Patients

Cited by 8 publications

References 9 publications

Integrating an evidence‐based intervention into clinical practice: ‘transitional relationship model’

Integrating an evidence‐based intervention into clinical practice: ‘transitional relationship model’

Discharge interventions from inpatient child and adolescent mental health care: a scoping review

Getting back to school : understanding adolescents' experience of reentry into school after psychiatric hospitalization

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