Special edition on inpatient treatment: A new annual tradition

et al. 2019

Australas Psychiatry

Objective: To characterise adolescents admitted to a voluntary adolescent inpatient unit and investigate treatment outcomes. Method: A retrospective cohort design was employed. Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) pre- and post-admission scores were collected, measuring global functioning. Demographic variables such as age, gender, primary diagnosis, comorbidity and length of stay (LOS) were analysed. Data were collected from May 2017 to April 2018. All adolescents admitted to the inpatient unit were included. Results: The majority of adolescents ( n = 72; HoNOSCA data available on n = 57) were 16 years of age (26%), female (82%) and with a primary diagnosis of a mood disorder (57%). Most adolescents improved at the time of discharge. Self-injury and emotional symptoms had greater reductions according to clinician and adolescent-self-ratings ( p < 0.01). Mean change (improvement) in HoNOSCA total score was 7.3 (SD 7.5) based on clinician ratings and 7.2 (SD 9.5) for adolescent-self-ratings. The mean LOS was 28 days (SD 15.8). Conclusions: The inpatient unit proved effective at meeting the needs of young people in terms of symptom stabilisation. Further research is needed to describe adolescent inpatient models of care, the operations and philosophies to better examine how these relate to treatment outcomes.

mentioning

confidence: 99%

A profile of adolescents admitted to a private inpatient unit and mental health outcomes

et al. 2019

Australas Psychiatry

“…primary care and services such as Headspace in Australia and Jigsaw in Ireland) and outpatient settings (e.g. individual or group private practice) (Author;Delaney, 2017). However, some young people experience their challenges as life-threatening and they and their families seek more intensive interventions such as those delivered within an inpatient unit (Delaney, 2017).…”

Section: Introductionmentioning

confidence: 99%

Experiences of an adolescent inpatient model of care: Adolescent and caregiver perspectives

Child Adoles Psych Nursing

et al. 2020

“…An increase in the admission rates of adolescents to emergency departments with mental health problems has been documented globally and is also reflected in Australia (Hagell, Coleman, & Brooks, ; Hiscock, Neely, Lei, & Freed, ; Office for National Statistics., ; Sawyer & Patton, ; Shanmugavadivel, Sands, & Wood, ). Despite attempts to treat adolescents with mental disorders in community settings and an increased focus on earlier intervention, inpatient units remain an important care option in the absence of evidence‐based alternatives (Delaney, ). The importance of the inpatient role in mental health care is consistent with the increasing rates of adolescent admissions (Blader, ; Hiscock et al, ; James, Clacey, Seagroatt, & Goldacre, ; Torio, Encinosa, Berdahl, McCormick, & Simpson, ).…”

Section: Introductionmentioning

confidence: 99%

“…It is also one of the most critical times for appropriate and early intervention possibly setting the course of lifelong management of disorders. Consequently, there is an urgent need to focus on inpatient unit programs, their effectiveness and how they relate to therapeutic outcomes, yet surprisingly little research has been conducted (Delaney, ).…”

Section: Introductionmentioning

confidence: 99%

The unheard voice of the clinician: Perspectives on the key features of an adolescent inpatient model of care

Child Adoles Psych Nursing

et al. 2019

Problem Little has been reported from clinicians about the operations, interventions, and outcomes of inpatient units and how these comprise models of care in such units. The aim of this study was to explore an inpatient model of care in operation at the study site by defining key features of the model from the perspectives of clinicians. Methods Semi‐structured face to face interviews were conducted with ten clinicians working in a private inpatient unit in Melbourne, Australia. Interview data were analyzed using thematic analysis. Findings Analysis resulted in the identification of three thematic features relating to containment, engagement, and therapy. These included (a) an environment conducive to containment, (b) adolescent engagement through shared experiences, and (c) dialectical behavior therapy embedded culture. Conclusions The findings provide insights into often unheard clinician perspectives on what the key features of an adolescent inpatient model of care are. These features relate to the interventions that are currently offered on the unit and ways of working as informed by philosophies and practices. These findings should be used to improve clinical services and inform research aiming to articulate exemplary adolescent inpatient models of care. Furthermore, the findings provide guidance and practical information to commissioners, clinicians, and policy makers implementing models of care.