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ERIC Number: EJ813495
Record Type: Journal
Publication Date: 2007-Dec
Pages: 9
Abstractor: As Provided
Reference Count: N/A
ISSN: ISSN-0021-9630
Inpatient Treatment in Child and Adolescent Psychiatry--A Prospective Study of Health Gain and Costs
Green, Jonathan; Jacobs, Brian; Beecham, Jennifer; Dunn, Graham; Kroll, Leo; Tobias, Catherine; Briskman, Jackie
Journal of Child Psychology and Psychiatry, v48 n12 p1259-1267 Dec 2007
Background: Inpatient treatment is a complex intervention for the most serious mental health disorders in child and adolescent psychiatry. This is the first large-scale study into its effectiveness and costs. Previous studies have been criticised for methodological weaknesses. Methods: A prospective cohort study, including economic evaluation, conducted in 8 UK units (total n = 150) with one year follow-up after discharge. Patients acted as their own controls. Outcome measurement was the clinician-rated Childhood Global Assessment Scale (CGAS); researcher-rated health needs assessment; parent- and teacher-rated symptomatology. Results: We found a significant (p less than 0.001) and clinically meaningful 12-point improvement in CGAS following mean 16.6 week admission (effect size 0.92); this improvement was sustained at 1 year follow-up. Comparatively, during the mean 16.4 week pre-admission period there was a 3.7-point improvement (effect size 0.27). Health needs assessment showed similar gain (p less than 0.001, effect size 1.25), as did teacher- and parent-rated symptoms. Improvement was found across all diagnoses. Longer stays, positive therapeutic alliance and better premorbid family functioning independently predicted better outcome. Mean cost of admission was 24,100 British Pounds; pre-admission and post-discharge support costs were similar. Conclusions: Inpatient treatment is associated with substantive sustained health gain across a range of diagnoses. Lack of intensive outpatient-treatment alternatives limits any unqualified inference about causal effects, but the rigour of measurement here gives the strongest indication to date of the positive impact of admission for complex mental health problems in young people.
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Publication Type: Journal Articles; Reports - Research
Education Level: N/A
Audience: N/A
Language: English
Sponsor: N/A
Authoring Institution: N/A
Identifiers - Location: United Kingdom