Journal of the American Academy of Child & Adolescent Psychiatry
ArticlesEvaluating the Use of Psychiatric Hospitalization by Residential Treatment Centers
Section snippets
Setting
This study was conducted through the Screening, Assessment, and Supportive Service (SASS) program within the State of Illinois child welfare system, the Illinois Department of Children and Family Services (DCFS). The SASS program was implemented in 1992 to provide crisis assessment and treatment services to children in protective custody who are referred for or are at risk of hospitalization. Referrals are made to SASS workers when a DCFS ward is demonstrating a risk of self-harm or injury to
RESULTS
Hospital referrals were placed into 1 of 2 categories: high-risk or low-risk. Referrals were deemed high-risk if they displayed moderate levels of suicidality, dangerousness to others, or psychotic symptoms. Therefore, a child who received a rating of 2 (with 3 being the highest possible rating) on any of these 3 variables of the CSPI was determined to be an appropriate referral. Children and adolescents who were rated as at most mild on all of these 3 variables were deemed low-risk. Therefore,
DISCUSSION
This study provides an empirical evaluation of one aspect of treatment quality among RTCs in one metropolitan county. There were notable variations in the percentage of low-risk referrals among RTCs, from zero to 50% of clients referred from different RTCs failing to meet the clinically appropriate threshold for a psychiatric hospital admission (according to the CSPI). It was not the case that low-risk referrals had different mental health needs; in fact, these referrals were rated lower on all
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Financial support for this project was provided by the Illinois Department of Children and Family Services.