Post-Discharge Services and Psychiatric Rehospitalization Among Children and Youth

James, Sigrid; Charlemagne, Sherma J.; Gilman, Amanda B.; Alemi, Qais; Smith, Rolland R.; Tharayil, Priya R.; Freeman, Kimberly

doi:10.1007/s10488-009-0263-6

Cited by 92 publications

(102 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…For instance, only 2% of participants in this study failed to receive any treatment after being discharged from the hospital, compared to 28% in a study of hospitalized children and adolescents published by James et al in 2010. 10 Rates of treatment utilization among the current sample were also substantially higher than the two thirds reported by Daniel et al in 2004. 11 …”

Section: Discussioncontrasting

confidence: 54%

“…8 The high rates of service use in these samples may be due to the fact that, unlike in the studies reviewed above, the participants were psychiatrically hospitalized, which suggests that they represented higher risk samples. Nonetheless, Spirito et al reported that, during a 3-month period after discharge, 18% terminated outpatient therapy against therapist advice, 9 and James et al found that, over a 30-month follow-up period, 28% of their sample of children and adolescents failed to receive any treatment following their first psychiatric hospitalization, 10 thus offering a less optimistic view of patterns of service use. In a review of data concerning children and adolescents who received inpatient psychiatric care, Daniel et al reported that, in general, two thirds or more of psychiatrically hospitalized youth received treatment of some kind following discharge from the hospital.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Follow-up Treatment Utilization by Hospitalized Suicidal Adolescents

Yen¹,

Fuller²,

Solomon³

et al. 2014

Journal of Psychiatric Practice

View full text Add to dashboard Cite

This study examines treatment utilization in a sample of 99 adolescents who were psychiatrically hospitalized due to a risk of suicide and followed for 6 months. Descriptive information regarding participants’ use of various forms of outpatient and intensive treatment, including emergency, inpatient, and residential care is presented. In addition, the relationships between utilization of mental health services and various characteristics of the adolescents and their families were assessed. Overall treatment engagement was high, with 78 participants (79%) receiving some care for the duration of the follow-up period and 91 (92%) participating in at least one session of outpatient treatment, although the extent of utilization was highly variable. In addition, 28 participants (28%) were rehospitalized during follow-up. Both family and individual characteristics were associated with differences in adolescents’ participation in follow-up treatment. Specifically, adolescents with a family history of mood disorders were more likely to participate in outpatient treatment and less likely to require intensive treatments. Conversely, more impaired baseline functioning and suicide attempts during the follow-up period were associated with greater utilization of intensive treatments and less utilization of outpatient therapy. Given that 19 participants (19%) in our sample attempted suicide during the follow-up interval, the findings of this study suggest that, in spite of high rates of outpatient treatment engagement, rates of suicide attempts and use of intensive treatment services remain high. These results suggest the need for improved outpatient care, as well as possibly longer inpatient stays and more elaborate discharge and transition planning.

show abstract

Section: Discussioncontrasting

confidence: 54%

mentioning

confidence: 99%

Follow-up Treatment Utilization by Hospitalized Suicidal Adolescents

Yen¹,

Fuller²,

Solomon³

et al. 2014

Journal of Psychiatric Practice

View full text Add to dashboard Cite

show abstract

“…The average youth psychiatric inpatient readmission rate ranges from 30% to 60% [15, 17, 18]. At least one-third of children and adolescents are more likely to be rehospitalized within the first 3 months to two years after the first admission [15–17]. Those who are at a younger age at admission are generally more likely to be readmitted [17, 19, 20].…”

Section: Introductionmentioning

confidence: 99%

Risk factors for rehospitalization and inpatient care among pediatric psychiatric intake response center patients

Tossone

Jefferis

Bhatta

et al. 2014

Child Adolesc Psychiatry Ment Health

View full text Add to dashboard Cite

BackgroundThe study sought to explore the characteristics, risk factors for inpatient recommendation, and risk factors for revisits to a pediatric psychiatric intake response center (PIRC). There are three research questions: 1. What is the general profile of pediatric patients who present at the PIRC? 2. What are the risk factors for patients who repeatedly visit the PIRC? 3. What are the risk factors for PIRC patients who are recommended to inpatient care?MethodsThe study utilized a retrospective medical chart review of a random sample (n = 260). A PIRC profile was created using frequency and prevalence calculations, in addition to a survival analysis of patients who return to the PIRC in order to determine how long it takes for PIRC patients to return to the PIRC. Factors that contribute to increased odds of returning to PIRC and being recommended for inpatient treatment were calculated using two logistic regression analyses.ResultsThe average pediatric PIRC patient is about 13 years old, Caucasian, with Medicaid and comes from a divorced or single parent household. About 43% of patients presented at PIRC for suicidal thoughts, ideation, intentions or actions. At least 63% of patients have a history of victimization. The average time to return to PIRC is about 90 days. Patients with a history of victimization, suicidal behavior, learning problems, problems with peers, and a history of violence were at an increased odds of returning to the PIRC. Those patients who were previously admitted to inpatient care and had a family history of mental health issues were at increased odds of being recommended to inpatient treatment.ConclusionsThis sample presents with a multitude of issues that contribute to increased odds of revisits to PIRC and inpatient recommendation. These issues seem to come from multiple levels of influence. Future research should expand to similar treatment facilities and use a prospective design to confirm risk factors. Treatment for pediatric psychiatric patients may focus on multiple factors that influence patients’ mental health.

show abstract

“…However, a significant number of adolescents continue to experience suicide-related outcomes after discharge, including rehospitalizations, emergency department visits (3), persistent suicidal ideation, and repeated suicidal behavior (4–7). Adolescent rehospitalization rates are high: 19%–28% are rehospitalized within six months (3,8), 38% within one year (9), and up to 43% within 2.5 years after discharge (10). The risk of rehospitalization is especially elevated during the first three months after discharge (9–11).…”

mentioning

confidence: 99%

Rehospitalization of Suicidal Adolescents in Relation to Course of Suicidal Ideation and Future Suicide Attempts

Czyz¹,

Berona²,

King³

2016

View full text Add to dashboard Cite

Objective Psychiatric hospitalization is essential in the clinical management of suicidal adolescents, and a considerable number of hospitalized adolescents are rehospitalized, yet little is known about how this experience may influence postdischarge outcomes. This study examined the association between rehospitalization within three months of index hospitalization and subsequent suicide attempts and suicidal ideation among adolescents. Methods Participants were 373 youths (13–17 years old) hospitalized because of suicide risk, and they were followed for one year. Using Cox regression, the investigators examined rehospitalization within three months of index hospitalization as a predictor of time to suicide attempt during the subsequent nine months. Using latent-class growth modeling, they also examined whether rehospitalization predicted a change in the nine-month course of three suicidal ideation trajectories (subclinical, elevated but fast declining, and chronically elevated). Results Rehospitalization was associated with greater risk of suicide attempts, above the effects of key covariates. Rehospitalization also predicted distinct changes in suicidal ideation trajectories: Within the elevated–fast declining and chronically elevated groups, rehospitalization predicted increases in ideation during the follow-up, with larger magnitude for the chronic group. In contrast, rehospitalization was associated with a decrease in follow-up suicidal ideation in the subclinical group. Conclusions Rehospitalization predicted a more severe course of suicide ideation for most of the adolescents, but it was protective for only a smaller subgroup with subclinical levels of ideation at index hospitalization. Our findings also suggest that rehospitalization is a strong indicator of future risk of suicide attempt. These findings have important implications for intervening with rehospitalized adolescents.

show abstract

Post-Discharge Services and Psychiatric Rehospitalization Among Children and Youth

Cited by 92 publications

References 47 publications

Follow-up Treatment Utilization by Hospitalized Suicidal Adolescents

Follow-up Treatment Utilization by Hospitalized Suicidal Adolescents

Risk factors for rehospitalization and inpatient care among pediatric psychiatric intake response center patients

Rehospitalization of Suicidal Adolescents in Relation to Course of Suicidal Ideation and Future Suicide Attempts

Contact Info

Product

Resources

About