Outcomes of inpatient psychiatric treatment for adolescents: A multiple perspectives evaluation

Clin Child Psychol Psychiatry. 2018 Jul;23(3):409-424. doi: 10.1177/1359104517739073. Epub 2017 Nov 3.

Abstract

Adolescent inpatient psychiatric treatment was evaluated from the multiple perspectives of clinicians, young people and parents using standardised measures and goal-based outcomes (GBOs). The sample included cases ( N = 128) discharged from a London adolescent unit between April 2009 and December 2015. Measures were completed at admission and discharge, and change in ratings was analysed to assess treatment outcomes. Ratings of clinicians and young people on the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) were compared. Adolescents demonstrated significant improvement across all measures from admission to discharge. Correlation between clinicians' and adolescents' HoNOSCA ratings was weak at admission ( r = .25) but stronger at discharge ( r = .63). Standardised effect sizes were larger for GBOs ( d = 1.73 and 3.16 for adolescent and clinician-rated goals, respectively) compared to all standardised measures ( d = 0.31-0.93). Improvement was observed across all measures of functioning and symptoms following inpatient treatment. Clinicians and young people developed better shared understanding of the problems from admission to discharge. GBOs are more sensitive to change compared to standardised measures and may be meaningfully adopted by inpatient units for routine outcome monitoring.

Keywords: Adolescent; GBOs; HoNOSCA; inpatient; outcomes.

MeSH terms

  • Adolescent
  • Female
  • Humans
  • Inpatients / statistics & numerical data*
  • Male
  • Mental Disorders / therapy*
  • Outcome Assessment, Health Care / methods*
  • Patient Admission
  • Patient Discharge
  • Patient Outcome Assessment
  • Personnel, Hospital / statistics & numerical data*
  • Psychiatric Department, Hospital / statistics & numerical data*