Experiences and satisfaction of children, young people and their parents with alternative mental health models to inpatient settings: a systematic review

Abstract

Community-based mental health services for children and young people (CYP) can offer alternatives to inpatient settings and treat CYP in less restrictive environments. However, there has been limited implementation of such alternative models, and their efficacy is still inconclusive. Notably, little is known of the experiences of CYP and their parents with these alternative models and their level of satisfaction with the care provided. Therefore, the main aim of this review was to understand those experiences of the accessibility of alternative models to inpatient care, as well as overall CYP/parental satisfaction. A searching strategy of peer-reviewed articles was conducted from January 1990 to December 2018, with updated searches conducted in June 2019. The initial search resulted in 495 articles, of which 19 were included in this review. A narrative synthesis grouped the studies according to emerging themes: alternative models, tele-psychiatry and interventions applied to crisis, and experiences and satisfaction with crisis provision. The identified articles highlighted increased satisfaction in CYP with alternative models in comparison with care as usual. However, the parental experiential data identified high levels of parental burden and a range of complex emotional reactions associated with engagement with crisis services. Furthermore, we identified a number of interventions, telepsychiatric and mobile solutions that may be effective when applied to urgent and emergency care for CYP experiencing a mental health crisis. Lastly, both parental and CYP experiences highlighted a number of perceived barriers associated with help-seeking from crisis services.

Physicians’ Use of the Computerized Physician Order Entry System for Medication Prescribing: Systematic Review

“…MMAT does not recommend assigning a single score based on the assessment [ 21 ]. However, in this review, we used a specific metric derived from a previous study [ 22 ]. To rate the quality of each of the studies to justify the reasons for the final inclusions and exclusions.…”

“…Studies were classified as high, medium, or low quality, depending on the number of criteria that were met. A study was considered high quality if all 5 MMAT criteria were met, medium if 3 or 4 criteria were met, and low when a study met 1 or 2 criteria [ 22 ].…”

Bridging the gap between the emergency department and outpatient care: feasibility of a short-term psychiatric crisis intervention for children and adolescents

“…In recent years, accumulating research in children and adolescents support the utilization of models of intervention during crisis that are implemented early and prevent the escalation of mental health issues through community-based approaches [ 23 ]. However, most of the recently published brief interventions are aimed at specific psychiatric emergencies, such as suicidality [ 8 , 24 ] and trauma exposure [ 25 , 26 ].…”

Demographic & clinical correlates of admission into a specialized psychiatric inpatient service for children and adolescents in Egypt: An observational retrospective study

“…In 2008, a systematic review (Shepperd et al, 2009) identified eight worldwide commonly used alternative models to inpatient care for young people with complex mental health needs, such as multisystemic therapy, day hospitals and intensive specialist outpatient service. However, a more recent review reported high levels of parental burden and complex emotional reactions associated with engagement with such alternative interventions (Vusio et al, 2019).…”