Evaluation of psychiatric liaison-services for adolescents in residential group homes.
OBJECTIVE
Adolescents in residential care are a high-risk population for psychiatric disorders. Due to limited access to outpatient treatment, crises often result in psychiatric hospitalizations. These crises are often accompanied by termination of supportive relationships, which increases the risk for further problems. To minimize hospitalizations and to stabilize the psychological state of these adolescents, we developed and evaluated a home-treatment intervention program based on psychiatric liaison-services and compared it to standard medical care (SMC).


METHODS
The intervention was applied in 11 German residential group homes (N = 288, M = 14.1 years, SD = 2.7), while adolescents from 15 institutions (N = 336, M = 13.6 years, SD = 3.0) served as a comparison group (CG) (SMC). The frequency and duration of psychiatric inpatient treatment episodes were documented and caregiver-reported behavioural symptoms were assessed at baseline and at 6 and 12 months postintervention.


RESULTS
In both groups, less than 10% of the adolescents were admitted to psychiatric wards. Compared to SMC, hospitalizations were of shorter duration in the intervention group (IG) (1.30 vs 2.47 days per head within 12 months, p < .001). In both groups, behavioural problems decreased overtime.


CONCLUSIONS
Applying a home-treatment intervention program to children in residential care helps to stabilize the developmental course of this high-risk population by shortening psychiatric inpatient treatment.
Besier
T
T
Department of Child & Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, Steinhoevelstr. 5, 89075 Ulm, Germany. tanja.besier@uniklinik-ulm.de
Fegert
J M
JM
Goldbeck
L
L
D000293:Adolescent; D000296:Adolescent Psychiatry; D000342:Affective Symptoms / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D000553:Ambulatory Care; D016022:Case-Control Studies; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D002665:Child Psychiatry; D005260:Female; D005500:Follow-Up Studies; D016352:Group Homes; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007389:Internal-External Control; D008297:Male; D010552:Personality Assessment / Q000706:statistics & numerical data; D011594:Psychometrics; D011613:Psychotherapy; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012017:Referral and Consultation; D012114:Residential Treatment
D011619:Psychotropic Drugs