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Abstract

Forty-six children admitted to short-term, usually 4-6-week child psychiatric inpatient treatment were evaluated from multiple perspectives on admission, at discharge, and at 5-month, one-year, and 3-year follow-ups. The majority of the patients showed an improvement in functioning over the course of the 3-year follow-up. However, the 3-year stability of parent, teacher and clinical ratings of the child was very high. Furthermore, the majority of children had a high level of symptoms at follow-ups. Conduct problems had the highest stability and predicted the poorest outcome. The results stress the importance of long-term follow-up of children discharged from child psychiatric tertiary services. In many of these cases, the problems were persistent chronic problems that require continued monitoring and evaluation over many years. Short-term hospitalization should be seen as a pathway to further assistance rather than a complete form of treatment.

Examining Outcomes of Acute Psychiatric Hospitalization Among Children

“…This means that a child with an initial report of ‘major problems’ in one area presented with ‘minor problems’ at post-test. These improvements are consistent with the findings of previous studies (e.g., Harnett et al, 2005; Mayes et al, 2001; Sourander & Leijala, 2002). Problems decreased at a statistically significant level in 12 of the 13 domains captured by the TSR scale.…”

“…While findings of the limited outcome literature are encouraging, definitive conclusions cannot be drawn due to small sample sizes, missing data, lack of control groups and standardized measures (Gavidia-Payne et al, 2003; Green et al, 2007; Rice et al, 2002; Sourander & Piha, 1998; Sourander & Leijala, 2002). Our knowledge is further limited due to few studies reflecting current short stays in care.…”

“…The Children’s Global Assessment Scale (CGAS) relies on an observational process and standard clinical interview to assess overall functioning of children inpatient treatment (Cornsweet Barber, 1990; Shaffer, Gould, Brasic & Ambrosini, 1983; Sourander & Leijala, 2002). Achenbach’s Child Behavior Checklists (CBCL/4–18 and CBCL/2–3) (Achenbach, 1991; 1992) consist of a total of 113 items comprised of eight syndrome scales that measure social problems, thought problems, attention problems, aggressive behavior, withdrawn, delinquent behavior and somatic complains; three subscales examine social competence as well as internalizing and externalizing behavior problems.…”

“A turn in the road, but still a rough journey” - Parent and child perspectives of outcomes after pre-adolescent inpatient psychiatric admission

“…However, while continuing to have follow-up care, her child’s behaviour deteriorated 11 months after inpatient discharge. This finding was very much in keeping with short to medium-term outcomes, where improvement was mostly found at five- and six-months post-discharge in previous studies [ 22 – 24 ]. The case vignette of TS008 (a child who needed inpatient readmission in his second year post-discharge) was in line with the existing literature of medium-to-long-term outcomes, for example a study [ 25 ] that found sustained improvement one year post-discharge, but negative changes in outcome within two years reported in an earlier review by Blotcky and colleagues [ 11 , 25 ].…”

The Relationship Between Caregiver Capacity and Intensive Community Treatment for Children with a Mental Health Crisis

“…This shift is prompted by the realization that hospitalization is restrictive, expensive, and of questionable effectiveness (Glied and Cuellar 2003;Sourander and Leijala 2002;Stroul 1993), and is supported by evidence that some intensive community-based treatments are less expensive and at least as effective (Henggler et al 2003). The process has also created the need to identify factors that are associated with crisis worker referral decisions and to evaluate the clinical effectiveness of those decisions.…”