Rates and predictors of aftercare services among formerly hospitalized adolescents: a prospective naturalistic study.
OBJECTIVE
To examine rates and predictors of aftercare use, lengths of service use, and predictors of the duration of aftercare service use among 180 adolescents monitored for up to 8.1 years after discharge from an inpatient psychiatry unit.


METHODS
Drawing upon the Anderson-Newman model of service use, severity of illness, enabling, and predisposing factors assessed during the hospitalization were examined as potential predictors of service use. Information about outpatient mental health specialty services after hospitalization was assessed repeatedly and verified with treatment records.


RESULTS
Seventy-three percent of adolescents received aftercare within the first month after discharge, and 92% eventually received outpatient services. Fifty-seven percent of adolescents remained in treatment 6 months after initiation of services. Psychiatric comorbidity, prior service use, and presence of a biological parent or grandparent in the home were related to initial service use. Psychiatric comorbidity and history of repeated suicide attempts were related to longer duration, and older age and minority group status were related to shorter duration of aftercare service use.


CONCLUSIONS
Most adolescents receive aftercare services, but there are certain groups that are relatively less likely to access or remain in services. Interventions to decrease the barriers to care in such groups may be beneficial.
Goldston
David B
DB
Department of Psychiatry and Behavioral Medicine, Wake Forrest University School of Medicine, Winston-Salem, NC 27157-1087, USA. goldston@wfubmc.edu
Reboussin
Beth A
BA
Kancler
Cynthia
C
Daniel
Stephanie Sergent
SS
Frazier
Patricia H
PH
Harris
Ashley E
AE
Kelley
Arthur E
AE
Reboussin
David M
DM
D000293:Adolescent; D016497:Adolescent Health Services / Q000706:statistics & numerical data*; D000328:Adult; D000359:Aftercare / Q000706:statistics & numerical data*; D002648:Child; D005260:Female; D005544:Forecasting; D006297:Health Services Accessibility; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000534:rehabilitation*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D009657:North Carolina; D011446:Prospective Studies; D016019:Survival Analysis; D013997:Time Factors; D014600:Utilization Review