nach oben

The Journal of Behavioral Health Services & Research

Erschienen in:

10.12.2015

An Innovative, Interdisciplinary Model of Care for Inpatient Child Psychiatry: an Overview

verfasst von: Molly M. Gathright, MD, Khiela J. Holmes, PhD, Ed M. Morris, Ph.D, De Angelo Gatlin, MS

Erschienen in: The Journal of Behavioral Health Services & Research | Ausgabe 4/2016

Einloggen, um Zugang zu erhalten

Abstract

There are profound effects of childhood psychiatric disorders on families and communities. Given that each year over half a million youth receive mental health services through inpatient psychiatric hospitals, focus on assessment and treatment strategies for this group is paramount The purpose of this paper is to present an overview of an innovative, evidenced-based model of inpatient child psychiatric care that challenges commonly used traditional practices of inpatient child psychiatry. The highlighted model utilizes an interdisciplinary approach to clarify psychiatric diagnoses; create a comprehensive biopsychosocial formulation of the child and family; establish a rational medication regimen; provide individually tailored recommendations; and address the “revolving door” of repeated psychiatric hospitalizations. Descriptive analyses are presented that provide demographic, developmental, and psychiatric characteristics of the children admitted to the unit. The potential benefits of using this innovative model with developmentally and psychiatrically complex children are discussed.

Costello EJ, Egger H, Angold A. 10-year research update review: The epidemiology of child and adolescent psychiatric disorders: I. methods and public health burden. Journal of the American Academy of Child & Adolescent Psychiatry. 2005; 44(10): 440–451. doi:10.1097/01.chi.0000172552.41596.6f CrossRef

Busch SH, Barry CL. Mental health disorders in childhood: Assessing the burden on families. Health Affairs. 2007; 26(4): 1088–1095. doi:10.1377/hlthaff.26.4.1088 CrossRefPubMed

Smith JP, Smith GC. Long-term economic costs of psychological problems during childhood. Social Science & Medicine. 2010; 71(1): 110–115. doi:10.1016/j.socscimed.2010.02.046 CrossRef

Blader JC. Acute inpatient care for psychiatric disorders in the United States, 1999 through 2007. Archives of General Psychiatry. 2011; 68(12): 1276–1283. doi:10.1001/archgenpsychiatry.2011.84 CrossRefPubMed

Blader JC, Martin A, Sood, AB, et al. The child unit. In: SS Sharfstein, FB Dickerson, JM Oldham (Eds). Textbook of Hospital Psychiatry. Washington, DC: American Psychiatric Publishing, 2009, pp. 37–54.

Sharfstein SS, Dickerson FB, Oldham JM. Introduction. In: SS Sharfstein, FB Dickerson, JM Oldham (Eds). Textbook of Hospital Psychiatry. Washington, DC: American Psychiatric Publishing, 2009, pp. xix-xxi.

Burns BJ, Hoagwood K, Mrazek, PJ. Effective treatment for mental disorders in children and adolescents. Clinical Child & Family Psychology Review. 1999; 2(4): 199–254. doi:10.1023/A :1021826216025

Glick ID, Sharfstein SS, Schwartz HI. Inpatient psychiatric care in the 21st Century: The need for reform. Psychiatric Services. 2011; 62(2): 206–209. doi:10.1176 /appi.ps.62.2.206

Case BG, Olfson M, Marcus SC, et al. Trends in the inpatient mental health treatment of children and adolescents in US community hospitals between 1990 and 2000. Archives of General Psychiatry. 2007; 64(1): 89–96. doi:10.1001/archpsyc.64.1.89 CrossRefPubMed

10.

Zito JM, Safer DJ, dosReis S, et al. Trends in the prescribing of psychotropic medications to preschoolers. Journal of the American Medical Association. 2000; 283(8): 1025–1030. doi:10.1001/jama.283.8.1025 CrossRefPubMed

11.

Bronfman ET. Inpatient child mental health treatment strategies to manage treatment. In: WK Northvale (Ed). The Traumatic Bond Between Psychotherapist and Managed Care. New York, NY: Jason Aronson, Inc., 1999, pp. 123–136.

12.

Meagher SM, Rajan A, Wyshak G, et al. Changing trends in inpatient care for psychiatrically hospitalized youth: 1991–2008. Psychiatric Quarterly. 2013; 84:159–168. doi:10.1007/s11126-012-9235-1 CrossRefPubMed

13.

Hoffman DA, Schiller M, Greenblatt JM, et al. Polypharmacy or medication washout: An old tool revisited. Neuropsychiatry Disease and Treatment. 2011; 7(1): 639–648. doi:10.2147/NDT.S24375 CrossRef

14.

Donovan A, Sigel L, Zera G, et al. Seclusion and restraint reform: An initiative by a child and adolescent psychiatric hospital. Child & Adolescent Psychiatry. 2003; 54(7): 958–959. doi:10.1176/appi.ps.54.7.958

15.

Karlin BE, Ziess RA. Best practices: Environmental and therapeutic issues in psychiatric hospital design: Towards best practices. Psychiatric Services. 2006; 57(10): 1376–1378. doi:10.1176 /appi.ps.57.10.1376

16.

Kazdin AE. Combined and multimodal treatments in child and adolescent psychotherapy: Issues, challenges, and research directions. Clinical Psychology: Science and Practice. 1996; 3(1): 69–100. doi:10.1111/j.1468-2850.1996.tb00059.x

17.

Mohr WK, Pumariega JA. Level systems: Inpatient programming whose time has passed. Journal of Child and Adolescent Psychiatric Nursing. 2005; 17(3), 113–125. doi:10 .1111/j.1744-6171.2004.tb00005.x

18.

Blader JC. Symptom, family, and service predictors of children’s psychiatric rehospitalization within one year of discharge. Journal of the American Academy of Child & Adolescent Psychiatry. 2004; 43(4): 440–451. doi:10.1097/01.chi.0000111368.94169.c6 CrossRef

19.

James S, Charlemagne SJ, Gilman AB, et al. Post discharge services and psychiatric rehospitalization among children and youth. Administration and Policy in Mental Health. 2010; 37: 433–445. doi:10.1007/s10488-009-0263-6.CrossRefPubMedPubMedCentral

20.

Fontanella CA, Zuravin SJ, Burry CL. The effect of a Medicaid managed care program on patterns of psychiatric readmission among adolescents: Evidence from Maryland. Journal of Behavioral Health Services & Research. 2006; 33(1): 39–52. doi:10.1007/s11414-005-9004-0CrossRef

21.

Fontanella CA. The influence of clinical, treatment, and healthcare system characteristics on psychiatric readmission of adolescents. American Journal of Orthopsychiatry. 2008; 78(2): 187–198. doi:10.1037/a0012557 CrossRefPubMedPubMedCentral

22.

Blanz, B, Schmidt, MH. Practitioner review: Preconditions and outcome of inpatient treatment in child and adolescent psychiatry. Journal of Child Psychology and Psychiatry. 2000; 41(6): 703–712. doi: 10.1111/1469-7610.00658 CrossRefPubMed

23.

Fite, PJ, Stoppelbein, L, Greening, L. Predicting readmission to a child psychiatric inpatient unit: The impact of parenting styles. Journal of Child and Family Studies. 2009; 18(5): 621–629. doi: 10.1007/s10826-009-9284-8 CrossRef

24.

Lakin, BL, Brambila, AD, Sigda, KB. Behavioral managed care and its effects in the readmission to a children’s residential treatment center. Residential Treatment for Children and Youth. 2007; 24(4): 315–326. doi: 10.1080/08865710802174400 CrossRef

25.

Martin A, Krieg H, Esposito F, et al. Reduction of restraint and seclusion through collaborative problem solving: A five-year prospective inpatient study. Psychiatric Services. 2008; 59(12): 1406–1412. doi:10.1176/appi.ps.59.12.1406 CrossRefPubMed

26.

United States Census Bureau. State and County QuickFacts. Available online at http://quickfacts.census.gov/qfd/states/05000.html. Accessed February 20, 2015.

27.

Mayes SD, Calhoun, SL, Krecko, VF, et al. Outcome following child psychiatric hospitalization. The Journal of Behavioral Health Services & Research. 2001; 28(1): 96–103. doi: 10.1016/S0163-8343(01)00153-0 CrossRef

28.

Campbell, JM. Internal and external validity of seven Wechsler Intelligence Scale for Children – Third Edition short forms in a sample of psychiatric inpatients. Psychological Assessment. 1998; 10(4): 431–434. doi: 10.1037/1040-3590.10.4.431 CrossRef

29.

Scahil, L, Jekel, J, Schilling, LS. Screening child psychiatric inpatients for communication disorders: A pilot study. Archives of Psychiatric Nursing. 1991; 5(1): 31–37. doi: 10.1016/0883-9417(91)90007-R CrossRef

30.

Giddan, JJ, Milling, L, Campbell, N. Unrecognized language and speech deficits in preadolescent psychiatric inpatients. American Journal of Orthopsychiatry. 1996; 66(1): 85–92. doi: 10.1037/h0080158 CrossRefPubMed

31.

Tossone, K, Jefferis, E, Bhatta, MP, et al. Risk factors for rehospitalization and inpatient care among pediatric psychiatric intake response center patients. Child and Adolescent Psychiatry and Mental Health. 2014; 8(27): 1–10. doi: 10.1186/1753-2000-8-27

32.

Greene, RW, Ablon, JS, Martin, A. Use of Collaborative Problem Solving to reduce seclusion and restraint in child and adolescent inpatient units. Psychiatric Services. 2006; 57(5): 610–612. doi: 10.1176/appi.ps.57.5.610 CrossRefPubMed

33.

Bardach, NS, Coker, TR, Zima, BT, et al. Common and costly hospitalizations for pediatric mental health disorders. Pediatrics. 2014; 133(4): 602–609. doi: 10.1542/peds.2013-3165 CrossRefPubMedPubMedCentral

34.

Green, J, Kroll, L, Imrie, D, et al. Health gain and outcome predictors during inpatient and related day treatment in child and adolescent psychiatry. Journal of the American Academy of Child and Adolescent Psychiatry. 2001; 40(3): 325–332. doi: 10.1097/00004583-200103000-00012 CrossRefPubMed

35.

Delaney KR. Learning to observe in context: Child and adolescent inpatient mental health assessment. Journal of Child and Adolescent Psychiatric Nursing. 2006; 19(4): 170–174. doi:10.1111/j.1744-6171.2006.00068.x CrossRefPubMed

36.

Giuliano KK, Giuliano AJ, Bloniasz E, et al. Liberal visitation policies may be in patients’ best interest. Nurse Manager. 2000; 31(5): 46–50. doi:10.1097/00006247-200005000-00019

37.

Stormshak EA, Dishion TJ. A school-based, family-centered intervention to prevent substance use: The family check-up. The Journal of Drug and Alcohol Abuse. 2009; 35: 227–232. doi: 10.1080/00952990903005908 CrossRef

38.

Greene RW, Ablon JS (Eds). Treating explosive kids: The collaborative problem-solving approach. New York, NY: Guilford Press, 2006.

39.

Greene RW. The explosive child: A new approach for understanding and parenting easily frustrated, chronically inflexible children, Second Edition. New York, NY: Harper Collins, 2001.

40.

Regan K, Curtin C, Vorderer L. Paradigm shifts in inpatient psychiatric care of children: Approaching child- and family-centered care. Journal of Child and Adolescent Psychiatric Nursing. 2006; 19(1): 29–40. doi:10.1111/j.1744-6171.2006.00040.x CrossRefPubMed

41.

Lochman JE, Wells KC. Contextual social-cognitive mediators and child outcome: A test of the theoretical model in the Coping Power program. Developmental Psychopathology. 2002; 14(4): 945–967. doi:10.1017/S0954579402004157 CrossRef

42.

Greene RW, Ablon JS, Goring JC. A transactional model of oppositional behavior: Underpinnings of the collaborative problem solving approach. Journal of Psychosomatic Research. 2003; 55: 67–75.CrossRefPubMed

43.

Holmes KJ, Stokes LD, Gathright MM. The use of collaborative problem solving to address challenging behavior among hospitalized children with complex trauma: A case series. Residential Treatment for Children & Youth. 2014; 31(1): 41–62. doi: 10.1080/0886571X.2014.878581 CrossRef

44.

American Academy of Child and Adolescent Psychiatry. Treatment guidelines: A guide for public child serving agencies on psychotropic medications for children and adolescents. Available online at http://www.aacap.org. Accessed May 15, 2014.

45.

Arnold, E, Goldston, D, Ruggiero, A, et al. Rates and predictors of rehospitalization among formerly hospitalized adolescents. Psychiatric Services. 2003; 54(7): 994–998. doi: 10.1176/appi.ps.54.994 CrossRefPubMed

46.

Vitiello B, Correll C, van Zwieten-Boot B, et al. Antipsychotics in children and adolescents: Increasing use, evidence for efficacy and safety concerns. European Neuropsychopharmacology. 2009; 19(9): 629–635. doi:10.1016/j.euroneuro.2009.04.008 CrossRefPubMed

47.

Correll CU, Penzer JB, Parikh UH, et al. Recognizing and monitoring adverse events of second generation antipsychotics in children and adolescents. Child Adolescent Psychiatric Clinics of North America. 2006; 15(1): 177–206. doi:10.1016/j.chc.2005.08.007 CrossRefPubMed

48.

Ko, SJ, Ford, JD, Kassam-Adams, N, et al. Creating trauma-informed systems: Child welfare, education, first responders, health care, juvenile justice. Professional Psychology: Research and Practice. 2008; 39(4): 396–404. doi: 10.1037/0735-7028.39.4.396 CrossRef

Titel: An Innovative, Interdisciplinary Model of Care for Inpatient Child Psychiatry: an Overview
verfasst von: Molly M. Gathright, MD
Khiela J. Holmes, PhD
Ed M. Morris, Ph.D
De Angelo Gatlin, MS
Publikationsdatum: 10.12.2015
Verlag: Springer US
Erschienen in: The Journal of Behavioral Health Services & Research / Ausgabe 4/2016
Print ISSN: 1094-3412
Elektronische ISSN: 2168-6793
DOI: https://doi.org/10.1007/s11414-015-9484-5

Neu im Fachgebiet Psychiatrie

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Wartezeit nicht kürzer, aber Arbeit flexibler

Psychotherapie Medizin aktuell

Fünf Jahren nach der Neugestaltung der Psychotherapie-Richtlinie wurden jetzt die Effekte der vorgenommenen Änderungen ausgewertet. Das Hauptziel der Novellierung war eine kürzere Wartezeit auf Therapieplätze. Dieses Ziel wurde nicht erreicht, es gab jedoch positive Auswirkungen auf andere Bereiche.

Chirurginnen und Chirurgen sind stark suizidgefährdet

07.05.2024 Suizid Nachrichten

Der belastende Arbeitsalltag wirkt sich negativ auf die psychische Gesundheit der Angehörigen ärztlicher Berufsgruppen aus. Chirurginnen und Chirurgen bilden da keine Ausnahme, im Gegenteil.

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Klinik aktuell Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Update Psychiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Klimawandel und Gesundheit: Was Sie in der Hausarztpraxis wissen müssen und tun können

Springer Medizin

An Innovative, Interdisciplinary Model of Care for Inpatient Child Psychiatry: an Overview

Abstract

Neu im Fachgebiet Psychiatrie

Darf man die Behandlung eines Neonazis ablehnen?

Wartezeit nicht kürzer, aber Arbeit flexibler

Chirurginnen und Chirurgen sind stark suizidgefährdet

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

Update Psychiatrie

Klimawandel und Gesundheit: Was Sie in der Hausarztpraxis wissen müssen und tun können

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 4/2016

A Statewide Pediatric Psychiatry Consultation to Primary Care Program and the Care of Children with Trauma-related Concerns

A Comparison of Methamphetamine Users to a Matched NHANES Cohort: Propensity Score Analyses for Oral Health Care and Dental Service Need

Introduction to the Special Section Positive Developmental Strategies for Engaging Emerging Adults and Improving Outcomes

Bridging the Gap Between Adolescence and Adulthood: the Challenges of Emerging Adults

Youth, Caregiver, and Staff Perspectives on an Initiative to Promote Success of Emerging Adults with Emotional and Behavioral Disabilities

An Engagement Intervention for Young Adults with Serious Mental Health Conditions

Neu im Fachgebiet Psychiatrie

Darf man die Behandlung eines Neonazis ablehnen?

Wartezeit nicht kürzer, aber Arbeit flexibler

Chirurginnen und Chirurgen sind stark suizidgefährdet

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

Update Psychiatrie