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Post-Discharge Services and Psychiatric Rehospitalization Among Children and Youth

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Abstract

This study examined risk and determinants of rehospitalization of children and adolescents (n = 186) following a first psychiatric hospitalization. It specifically examined the role of post-discharge services. Data were collected for a 30-month follow-up period through structured telephone interviews with caregivers and case record abstractions. 43% of youth experienced readmissions during the follow-up period. Risk of rehospitalization was highest during the first 30 days following discharge and remained elevated for 3 months. 72% of youth received 284 post-discharge services during the follow-up period, which significantly reduced the risk of rehospitalization. Longer first hospitalizations and a higher risk score at admission increased risk.

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Notes

  1. Clinical personnel indicated that the discharge diagnosis is more reliable than the admission diagnosis, which is generally considered an initial ‘working’ diagnosis.

  2. It should be noted that we did not include medication usage as a covariate in this analysis as all patients were discharged with medications, most with multiple medications, and many had been on medication prior to their first hospitalization. We also did not include insurance type as 90% of respondents in this sample had private insurance.

  3. These youths did not differ from other youths receiving different combinations of post-discharge services in terms of their clinical severity.

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Acknowledgments

This study was supported by The Silberman Faculty Grant Program (PI: S. James) and in part by NIMH Grant K01 MH077732-01A1 I (PI: S. James). Preliminary findings of this study were presented at the 13th Annual Conference of the Society for Social Work and Research, New Orleans, LA, January 16, 2009 under the title “Predicting and preventing the risk of psychiatric rehospitalization among children and adolescents.”

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Authors and Affiliations

  1. Department of Social Work & Social Ecology, Loma Linda University, Loma Linda, CA, 92350, USA

    Sigrid James, Sherma J. Charlemagne, Amanda B. Gilman, Qais Alemi, Rhoda L. Smith, Priya R. Tharayil & Kimberly Freeman

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  1. Sigrid James
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  2. Sherma J. Charlemagne
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Correspondence to Sigrid James.

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James, S., Charlemagne, S.J., Gilman, A.B. et al. Post-Discharge Services and Psychiatric Rehospitalization Among Children and Youth. Adm Policy Ment Health 37, 433–445 (2010). https://doi.org/10.1007/s10488-009-0263-6

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