Appropriate aftercare and discharge for mental health and psychiatric inpatient stays in hospitals

This study examined predictors of readmission for a sample of 522 adolescents enrolled in Medicaid and admitted to three inpatient psychiatric hospitals in Maryland. Comprehensive data on clinical, treatment, and health care system characteristics were collected from archival sources (medical records, Medicaid claims, and the Area Resource File). Predictors of readmission were examined with bivariate (Kaplan Meier) and multivariate (Cox Regression) survival techniques. One-year readmission rates were 38% with the majority occurring within 3 months after discharge...

Inpatient care is expensive and should ideally be provided for children and adolescents with the most serious psychiatric disorders. However, only little is known about inpatient treatment, e.g. the factors influencing hospital admission, the content of care in the hospital, the appropriate norms for the duration of inpatient stays, the inpatient arrangements that result in the best outcomes, or connection with necessary aftercare services. There are many methodological problems with existing research. However, it can cautiously be concluded that psychiatric hospitalisation of children and adolescents is often beneficial, particularly if special aspects of treatment are fulfilled (e...

Health care reform has had a profound effect on the way psychiatric treatment occurs in this country. Decreasing length of stay, increasing acuity, and reducing staff levels are making traditional approaches to mental health care infeasible. Resources already in place may still be focusing on long-term treatment issues and do not facilitate rapid stabilization and discharge planning that includes continued care within an integrated system. Research supports the feasibility of quality mental health care, which can be accomplished in shortened lengths of stay, as long as clinical managers plan inpatient programs focused on short-term goals followed by appropriate aftercare...

OBJECTIVE: The study examined demographic and clinical characteristics of frequent users of mental health services at a large community hospital in an urban-suburban area in Canada to identify subgroups within this patient population. METHODS: Patients who had had three or more inpatient admissions over any 12-month period between January 1, 1993, and December 31, 1995, were included in the study. Medical records were reviewed to collect summary data on 23 variables encompassing demographic characteristics and admission and discharge information...

A project is described whereby in 12 months, 105 long-stay psychiatric patients were able to be discharged to the homes of private individuals to become members of a 'family', to whom they were not related. The task necessitated a change in attitudes of the whole hospital staff--as resistance to change was encountered in staff at all levels. A consultant psychiatrist and a social worker interviewed all the long-stay patients in the wards and with the charge nurse decided whether they could live outside the hospital given an appropriate environment...