A rapid-response outpatient model for reducing hospitalization rates among suicidal adolescents.
OBJECTIVE
The authors studied the clinical outcomes of suicidal adolescents who were treated within a rapid-response outpatient model in a setting in which a ten-day wait was usually required before outpatient treatment could be started, leaving hospitalization as the only immediately available alternative.


METHODS
A total of 286 suicidal adolescents aged 12 to 17 years who came to the emergency department of a pediatric hospital were assigned to receive rapid-response outpatient follow-up (the experimental group) or to a control group. Demographic and clinical data were obtained at baseline, and outcomes data were obtained at two and six months.


RESULTS
The demographic and clinical characteristics of the two groups were similar at baseline. Hospitalization rates in the experimental and control groups, respectively, were 10 percent and 40 percent at baseline, 17 percent and 41 percent at two-month follow-up, and 18 percent and 43 percent at six-month follow-up, corresponding to a relative risk of hospitalization of.41 in the experimental group at six months. No between-group differences were observed in changes in levels of suicidality or in overall functioning over the follow-up period, and none of the patients had died at six months.


CONCLUSIONS
Suicidal adolescents who received rapid-response outpatient follow-up had a lower hospitalization rate than those who did not. The two groups achieved similar increases in levels of functioning and decrease in levels of suicidality, suggesting that suicidal adolescents can be treated within a rapid-response outpatient model and thus avoid hospitalization.
Greenfield
Brian
B
of Medicine, MCGill University, Montreal, Quebec, Canada. brian.greenfield@muhc.mcgill.ca
Larson
Charles
C
Hechtman
Lily
L
Rousseau
Cecile
C
Platt
Robert
R
D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data; D002648:Child; D004637:Emergency Services, Psychiatric / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology; D013406:Suicide, Attempted / Q000517:prevention & control* / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013997:Time Factors