The Exploratory Evaluation of an Inpatient Model of Care for Adolescents Experiencing Mental Health Problems: A Prospective Longitudinal Study

© 2019 Claire HayesAdolescent mental health research is a developing area. Existing treatment guidelines for adolescent mental health care in most western countries emphasise the role of inpatient care when needed. Inpatient units are the most widely used acute element of adolescent mental health services internationally. Yet little is known about inpatient units, their therapeutic operations, models of care and perceived helpfulness. Less is known about general adolescent inpatient units from the perspectives of adolescents, caregivers and clinicians. In order to address this gap in understanding an adolescent inpatient model of care in operation, a prospective mixed-methods approach was adopted. Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) were collected, measuring global functioning at T1 (admission) and T2 (discharge). Semi-structured interviews were conducted with 16 adolescents and 12 caregivers at T1, T2 and T3 (six months post discharge). Qualitative data were first analysed thematically followed by a trajectory analysis. One-off semi-structured interviews were conducted with clinicians (n=10) and analysed using thematic analysis. Data collection began in May 2017 and ceased in October 2018. The majority of adolescents (n=72) were 16 years of age (26%), female (82%) and with a primary diagnosis of a mood disorder (57%). HoNOSCA data were completed by clinicians (n=57) and adolescents (n=56). Most adolescents improved at the time of discharge. Self-injury and emotional symptoms had greater reductions according to clinician and adolescent-self-ratings (p