Psychiatric Rehospitalization of Children and Adolescents: Implications for Social Work Intervention

Abstract

This study explored factors associated with the psychiatric rehospitalization of children and adolescents. A retrospective archival review was conducted on 403 children and adolescents admitted into an inpatient psychiatric hospital. Results indicated that 16% were readmitted in the same year. Children and adolescents who had a prior history of psychiatric rehospitalization, lived in a residential treatment facility, and had a diagnosis of oppositional/defiant or conduct disorder were more likely to be rehospitalized. Psychosocial factors must be considered in predicting and preventing psychiatric rehospitalization. Clinical social workers should include therapeutic foster care as an option for aftercare placements of youth exhibiting externalizing behaviors and/or with a history of multiple restrictive care placements.

Predictors of Rehospitalization for Depressed Adolescents Admitted to Acute Psychiatric Treatment

“…In view of the alarming prevalence 7–9 and costs of repeated hospitilizations, 14 the current study aimed to identify predictors of rehospitalization in depressed adolescents admitted to a short-term residential treatment service. Over 12% of our sample were readmitted to the same residential service within 6 months of discharge, a rate that is similar to that in previous studies.…”

“…10,13 Nonetheless, there is a dearth of studies that have investigated potential predictors of rehospitalization among adolescent psychiatric samples. 14 To address this empirical gap, the present study recruited a sample of depressed adolescents admitted to a short-term residential unit and tested whether key demographic and clinical characteristics were associated with rehospitalization within 6 months of discharge.…”

Examining Outcomes of Acute Psychiatric Hospitalization Among Children

“…A review of the combined literature indicates that most outcome studies of child and adolescent inpatient psychiatric care assess outcomes in terms of symptom reduction, quality of care indicators, such as rehospitalization, and service effectiveness outcomes, such as cost of services (Chung, Edgar-Smith, Palmer, Bartholomew & Delambo, 2008; Fontanella, 2008; Hoagwood et al, 1996; Pottick, Hansell, Miller & Davis, 1999). These studies generally report significant improvements in child behavior and emotional symptoms (Gavidia-Payne, Littlefield, Hallgren, Jenkins, & Coventry, 2003; Swadi & Bobier, 2005) as well as overall functioning (Gold et al, 2009).…”

“…A number of studies have investigated child, family and service factors in relation to inpatient psychiatric outcome (e.g., Chung et al, 2008; Fontanella, 2008; Harnett, Loxton, Sadler, Hides, & Baldwin 2005; James et al, 2010) either as predictor or mediator variables. Findings of these studies have been inconsistent depending on methodology used, but factors such as clinical diagnosis and symptom severity, length of stay in care and prior hospitalizations have been relatively consistent predictors across studies (see Chung et al, 2008 and Fontanella, 2008 for a review of this literature).…”

“…Findings of these studies have been inconsistent depending on methodology used, but factors such as clinical diagnosis and symptom severity, length of stay in care and prior hospitalizations have been relatively consistent predictors across studies (see Chung et al, 2008 and Fontanella, 2008 for a review of this literature). In most studies, greater symptom severity has been associated with poorer outcome (e.g., Fontanella, 2008); however, Mayes et al (2001) determined that greater symptom severity was associated with a higher rate of change.…”