Occupied bed days a redundant currency? An evaluation of the first 10 years of an integrated model of care for mentally ill adolescents

Clin Child Psychol Psychiatry. 2015 Jul;20(3):458-71. doi: 10.1177/1359104514527298. Epub 2014 Apr 1.

Abstract

Background: We report on clinical outcomes from the first 10 years of operation of an Adolescent Assertive Outreach Team (AAOT) which forms part of an integrated Tier 4 service offering inpatient, day-patient and intensive community treatment.

Method: Prospective data were recorded at pre- and post-treatment for patients accepted for treatment by the AAOT over a 10-year period.

Results: A total of 393 adolescents were treated by the AAOT, and 135 received some hospital care as part of their treatment. Contact periods with the team were significantly shorter for those treated wholly in the community. Outcome measures indicated severe pathology at onset with substantial improvement in function regardless of whether treatment involved hospital care or community support only.

Conclusions: Adolescent Outreach is a viable and sustainable alternative to inpatient care for some young people referred for admission, reducing but not eliminating the need for acute beds.

Keywords: Adolescent; Tier 4; child and adolescent mental health services; integrated model; intensive community treatment; service provision.

MeSH terms

  • Adolescent
  • Adolescent Health Services*
  • Child
  • Community Mental Health Services / methods*
  • Depressive Disorder / therapy
  • Female
  • Hospitalization*
  • Humans
  • Male
  • Mental Disorders / therapy*
  • Mood Disorders / therapy
  • Psychotic Disorders / therapy