AT_HOME: Long-Term Outcomes of a Psychiatric Home Treatment for Children and Adolescents as an Alternative to Inpatient Treatment

Aims: "AT_HOME" is a pilot project for home-based treatment of children and adolescents with acute mental disorders which aims to replace patients' hospitalization. Instead of being admitted to a clinic, the young patients stay at home and are visited by the treatment team. Previous research has illustrated the short-term effectiveness of this program in terms of clinical outcomes. The aim of the present study was to investigate the long-term stability of treatment effects compared to an inpatient control group. Methods: Patients treated in AT_HOME (n=34) or in an inpatient unit at the CAP (n=90, non-randomized) between 05/2019 and 07/2020 in Bern (Switzerland) were contacted 18 months after discharge from treatment. Psychosocial functioning was assessed with the Global Assessment of Functioning Scale (GAF), general psychopathological burden was assessed using the Health of the Nation Outcome Scale for Children and Adolescents (HoNOSCA[-SR]). Assessments were double scored by a blinded researcher, interrater reliability was high. Results and Conclusions: 75 former patients (61% female, 15.92 ± 2.87 years) participated in the study. 18 months after discharge, patients from the AT_HOME group showed significantly lower psychopathological burden and higher levels of psychosocial functioning compared with patients from the inpatient group according to clinician rating. Patients did not differ in their self-rated psychopathological burden. The findings of the current study provide further evidence that home treatment is a promising alternative to hospitalization for children and adolescent with acute mental disorders, resulting in a more beneficial trajectory after therapy discharge compared to inpatient treatment