Adolescent Inpatient Mental Health Admissions: An Exploration of Interpersonal Polyvictimization, Family Dysfunction, Self-Harm and Suicidal Behaviours

Stewart, Shannon L.; Semovski, Valbona; Lapshina, Natalia

doi:10.1007/s10578-022-01450-4

Cited by 7 publications

(6 citation statements)

References 86 publications

(107 reference statements)

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“…Child and adolescent psychiatric care is generally provided in outpatient settings; however, a small group of patients occasionally requires inpatient care to stabilize lifethreatening conditions [1,2]. The first days of emergency admission seem to add the most value, while longer admissions carry risks of symptom escalation, contagion of self-harm, and disconnection from friends, family, and school [1,3,4]. For emotionally unstable, often self-harming, or suicidal patients, the pathway to admission may be perceived as a struggle that is, at times, marked by rejection at some times and involuntary admissions at others.…”

Section: Introductionmentioning

confidence: 99%

Implementation of Brief Admission by Self-Referral in Child and Adolescent Psychiatry in Sweden: Insights from Implementers and Staff

Johansson,

Holmström,

Westling

et al. 2023

IJERPH

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Brief admission by self-referral, which allows patients to briefly admit themselves to a psychiatric ward, is a crisis intervention designed to reduce suicide and self-harm. This method was introduced in Sweden for adult patients in 2015, achieving high patient satisfaction and good acceptance among staff. In 2018, the method was adapted and implemented in pediatric psychiatry. The present study comprehensively describes the multifaceted strategies for implementing brief admissions, including planning, education, financing, restructuring, quality management, and policy implementation and reform. It also includes staff’s opinions of the practice of brief admissions for young people. Neither of these topics has been addressed in the existing literature. During the study period (April 2018–April 2021), 63 brief admission contracts were established. The number of new contracts increased exponentially (12.7%) per quarter (p < 0.05), and staff satisfaction with both the implementation and its benefits for unstable patients was high. Brief admission by self-referral can be successfully implemented in pediatric psychiatry and appears to be a functional crisis management method for adolescents.

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Section: Introductionmentioning

confidence: 99%

Implementation of Brief Admission by Self-Referral in Child and Adolescent Psychiatry in Sweden: Insights from Implementers and Staff

Johansson,

Holmström,

Westling

et al. 2023

IJERPH

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“…These latter behaviors have all been associated with emotion dysregulation (Herts et al, 2012; Turton et al, 2021; Wolff et al, 2019). Family dysfunction has also been reported as a risk factor for admission to adolescent inpatient psychiatric units (Stewart et al, 2022).…”

mentioning

confidence: 99%

Implementing patient-reported outcome measures on an adolescent inpatient psychiatry unit: A feasibility study.

Waitz,

Caracansi,

Kaufman

et al. 2024

Psychological Services

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“…However, they can also be lengthy with interpersonal disconnection [4]. This is especially true for CYP who experience repeated admissions [5].…”

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confidence: 99%

Evaluation of intensive community care services for young people with psychiatric emergencies: study protocol for a multi-centre parallel group, single-blinded randomised controlled trial with an internal pilot phase.

Thaventhiran,

Wong,

Pilecka

et al. 2024

Preprint

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Background Over 3,000 young people under the age of 18 are admitted to Tier 4 Child and Adolescent Mental Health Services (CAMHS) inpatient units across the UK each year. The average length of hospital stay for young people across all psychiatric units in the UK is 120 days. Research is needed to identify the most effective and efficient ways to care for young people (YP) with psychiatric emergencies. This study aims to evaluate the clinical effectiveness and cost-effectiveness of intensive community care service (ICCS) compared to treatment as usual (TAU) for young people with psychiatric emergencies. Methods This is a multicentre two-arm randomized controlled trial (RCT) with an internal pilot phase. Young people aged 12 to < 18 considered for admission at participating NHS organisations across the UK will be randomized 1:1 to either TAU or ICCS. The primary outcome is the time to return to or start education, employment, or training (EET) at six-months post randomisation. Secondary outcomes will include evaluations of mental health and overall well-being and patient satisfaction. Service use, and costs and cost-effectiveness will also be explored. Intention-to-treat analysis will be adopted. The trial is expected to be completed within 42 months, with an internal pilot phase in the first 12 months to assess the recruitment feasibility. A process evaluation using visual semi-structured interviews will be conducted with 42 young people and 42 healthcare workers. Discussion This trial is the first well-powered randomised controlled trial evaluating the clinical and cost-effectiveness of ICCS compared to TAU for young people with psychiatric emergencies in Great Britain. Trial registration : ISRCTN: ISRCTN42999542

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Adolescent Inpatient Mental Health Admissions: An Exploration of Interpersonal Polyvictimization, Family Dysfunction, Self-Harm and Suicidal Behaviours

Cited by 7 publications

References 86 publications

Implementation of Brief Admission by Self-Referral in Child and Adolescent Psychiatry in Sweden: Insights from Implementers and Staff

Implementation of Brief Admission by Self-Referral in Child and Adolescent Psychiatry in Sweden: Insights from Implementers and Staff

Implementing patient-reported outcome measures on an adolescent inpatient psychiatry unit: A feasibility study.

Evaluation of intensive community care services for young people with psychiatric emergencies: study protocol for a multi-centre parallel group, single-blinded randomised controlled trial with an internal pilot phase.

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