Hostname: page-component-7c8c6479df-27gpq Total loading time: 0 Render date: 2024-03-29T07:13:23.939Z Has data issue: false hasContentIssue false

Evaluation of psychiatric liaison-services for adolescents in residential group homes

Published online by Cambridge University Press:  16 April 2020

T. Besier*
Affiliation:
Department of Child & Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, Steinhoevelstr. 5, 89075Ulm, Germany
J.M. Fegert
Affiliation:
Department of Child & Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, Steinhoevelstr. 5, 89075Ulm, Germany
L. Goldbeck
Affiliation:
Department of Child & Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, Steinhoevelstr. 5, 89075Ulm, Germany
*
*Corresponding author. Tel.: +49 731 500 61639. E-mail address: tanja.besier@uniklinik-ulm.de (T. Besier).
Get access

Abstract

Objective

Adolescents in residential care are a high-risk population for psychiatric disorders. Due to limited access to outpatient treatment, crises often result in psychiatric hospitalizations. These crises are often accompanied by termination of supportive relationships, which increases the risk for further problems. To minimize hospitalizations and to stabilize the psychological state of these adolescents, we developed and evaluated a home-treatment intervention program based on psychiatric liaison-services and compared it to standard medical care (SMC).

Methods

The intervention was applied in 11 German residential group homes (N = 288, M = 14.1 years, SD = 2.7), while adolescents from 15 institutions (N = 336, M = 13.6 years, SD = 3.0) served as a comparison group (CG) (SMC). The frequency and duration of psychiatric inpatient treatment episodes were documented and caregiver-reported behavioural symptoms were assessed at baseline and at 6 and 12 months postintervention.

Results

In both groups, less than 10% of the adolescents were admitted to psychiatric wards. Compared to SMC, hospitalizations were of shorter duration in the intervention group (IG) (1.30 vs 2.47 days per head within 12 months, p < .001). In both groups, behavioural problems decreased overtime.

Conclusions

Applying a home-treatment intervention program to children in residential care helps to stabilize the developmental course of this high-risk population by shortening psychiatric inpatient treatment.

Type
Original article
Copyright
Copyright © Elsevier Masson SAS 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Achenbach, TMManual for the Child Behavior Checklist/4–18 and 1991 Profile 1991 University of Vermont, Department of Psychiatry BurlingtonGoogle Scholar
Arbeitsgruppe Deutsche Child Behavior Checklist. Elternfragebogen über das Verhalten von Kindern und Jugendlichen; deutsche Bearbeitung der Child Behavior Checklist (CBCL/4-18). Einführung und Anleitung zur Handauswertung. 2. Auflage mit deutschen Normen. 2nd ed. Köln: Arbeitsgruppe Kinder-, Jugend- und Familiendiagnostik; 1998.Google Scholar
Barber, JGPlacement stability and the psychosocial well-being of children in foster care. Res Soc Work Pract 2003;13:415431CrossRefGoogle Scholar
Blanz, BSchmidt, MHPractitioner review: Preconditions and outcome of inpatient treatment in child and adolescent psychiatry. J Child Psychol Psychiat 2000;41:703712CrossRefGoogle Scholar
Blower, AAddo, AHodgson, JLamington, LTowlson, KMental health of ‘Looking After’ children: A needs assessment. Clinc Child Psychol Psychiatry 2004;9:117129CrossRefGoogle Scholar
Bundesarbeitsgemeinschaft Leitender Klinikärzte für Kinder- und Jugendpsychiatrie PuP. Leitlinien zur Diagnostik und Therapie von psychischen Störungen im Säuglings-, Kindes- und Jugendalter. 3.edition ed. Deutscher Ärzte-Verlag; 2007.Google Scholar
Burns, BJPhillips, SDWagner, HRBarth, RPKolko, DJCampbell, Yet al.Mental health need and access to mental health services by youths involved with child welfare: A national survey. J Am Acad Child Adolesc Psychiatry 2004;43:960970CrossRefGoogle ScholarPubMed
Callaghan, JYoung, BPace, FVostanis, PEvaluation of a new mental health service for looking after children. Clin Child Psychol Psychiatry 2004;9:130148CrossRefGoogle Scholar
Catty, JBurns, TKnapp, MWatt, HWright, CHenderson, Jet al.Home treatment for mental health problems: a systematic review. Psychol Med 2002;32:383401CrossRefGoogle ScholarPubMed
Evans, MEBoothroyd, RAArmstrong, MIGreenbaum, PEBrown, ECKuppinger, ADAn experimental study of the effectiveness of intensive in-home crisis services for children and their families: Program Outcomes. J Emotional Behav Disord 2003;11:92102CrossRefGoogle Scholar
Ford, TVostanis, PMeltzer, HGoodman, RPsychiatric disorder among British children looked after by local authorities: comparison with children living in private households. Br J Psychiatry 2007;190:319325CrossRefGoogle ScholarPubMed
Garland, AFHough, RLMcCabe, KMYeh, MWood, PAAarons, GAPrevalence of psychiatric disorders in youth across five sectors of care. J Am Acad Child Adolesc Psychiatry 2001;40:409418CrossRefGoogle Scholar
Geen R, Sommers A, Cohen M. Medicaid Spending of Foster Children. 2005.Google Scholar
Graf, EBitzer, MZimmermann-Wagner, MHerausforderung Kinderdorf: Ergebnisse der Kinderdorf-Effekte-Studie (KES). Unsere Jugend 2002;12:527539Google Scholar
Green, JJacobs, BCurrent challengesGreen, JJacobs, BIn-patient child psychiatry. Modern practice, research and the future 1998 Routledge London38Google Scholar
Henggeler, SWRowland, MRRandall, JWard, DPickrel, SGCunningham, PBet al.Home-based multisystemic therapy as an alternative to hospitalization of youth in psychiatric crisis: Clinical outcomes. J Am Acad Child Adolesc Psychiatry 1999;38:13311339CrossRefGoogle ScholarPubMed
James, SLandsverk, JSlymen, DJLeslie, LKPredictors of outpatient mental health service use – The role of foster care placement change. Ment Health Serv Res 2004;6:127141CrossRefGoogle ScholarPubMed
Knab, EMacsenare, MDie Jugendhilfe-Effekte-Studie (JES). Jugendwohl 1997;78:201209Google Scholar
Kobayashi, MNorcross, JCTreating anger in psychotherapy: Introduction and cases. Clin Psychol 1999;55:275282Google Scholar
Kommission der europäischen Gemeinschaften. Die psychische Gesundheit der Bevölkerung verbessern - Entwicklung einer Strategie für die Förderung der psychischen Gesundheit in der Europäischen Union. Brüssel: Kommission der Europäischen Gemeinschaften; 2005.Google Scholar
Lay, BBlanz, BSchmidt, MHEffectiveness of home treatment in children and adolescxents with externalizing psychiatric disorders. Eur Child Adolesc Psychiatry 2001;10:8090CrossRefGoogle ScholarPubMed
Mc Cann, JBJames, AWilson, SDunn, GPrevalence of psychiatric disorders in young people in the care system. BMJ 1996;313:15291530CrossRefGoogle Scholar
Meltzer, HGatward, RGoodman, RFord, TJMental health of children and adolescents in Great Britain 2000 Stationary Office LondonCrossRefGoogle Scholar
Meltzer, HGatward, RGoodman, RFord, TMental health of children and adolescents in Great Britain. Int Rev Psychiatry 2003;15:185187CrossRefGoogle ScholarPubMed
Newton, RRLitrownik, AJLandsverk, JAChildren and youth in foster care: Disentangling the relationship between problem behaviors and number of placements. Child Abuse Negl 2000;24:13631374CrossRefGoogle Scholar
Schmeck, KPoustka, FDopfner, MPluck, JBerner, WLehmkuhl, Get al.Discriminant validity of the child behaviour checklist CBCL-4/18 in German samples. Eur Child Adolesc Psychiatry 2001;10:240247CrossRefGoogle Scholar
Schmid, MPsychische Gesundheit von HeimkindernEine Studie zur Prävalenz psychischer Störungen in der stationären Jugendhilfe 2007 Juventa Weinheim, MünchenGoogle Scholar
Schmid M, Goldbeck L, Nuetzel J, Fegert JM. Prevalence of mental disorders among adolescents in German youth welfare institutions. Child and Adolescent Psychiatry and Mental Health 2008; 2:2:doi:10.1186/1753-2000-2-2.CrossRefGoogle Scholar
Schmidt, MHLay, BGöpel, CNaab, SBlanz, BHome treatment for children and adolescents with psychiatric disorders. Eur Child Adolesc Psychiatry 2006;15:265276CrossRefGoogle ScholarPubMed
Schmidt, MHSchneider, KHohm, EPickartz, AMascenare, MPetermann, Fet al.Effekte erzieherischer Hilfen und ihre Hintergründe 2002 Kohlhammer StuttgartGoogle Scholar
Schoenwald, SKWard, DMHenggeler, SWRowland, MDMultisystemic therapy versus hospitalization for crisis stabilization of youth: placement outcomes 4 month postreferral. Ment Health Serv Res 2000;2:312CrossRefGoogle Scholar
Sondheimer, DISchoenwald, SKRowland, MDAlternatives to the hospitalization of youth with a serious emotional disturbance. J Clin Child Psychol 1994;23:712Google Scholar
Strauss, GChassin, MLock, JCan experts agree when to hospitalize adolescents?. J Am Acad Child Adolesc Psychiatry 1995;34:418424CrossRefGoogle ScholarPubMed
Woolston, JLBerkowitz, SJSchaefer, MCIntensive, integrated, inhome psychiatric services. Child Adolesc Psychiatr Clin N Am 1998;7:615633CrossRefGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.