title: Treatment recidivism in adolescents with mental illness: A focused applied medical ethnography.
abstract: OBJECTIVE
  Treatment recidivism, described as frequent unplanned relapse readmissions, is a national problem predominant in adolescents with mental illness. Because the main triggers of treatment recidivism are not fully understood, the purpose of this study was to explore treatment recidivism (i) to better understand treatment recidivism from the perspectives of recidivist adolescents with mental illness, (ii) to describe major factors that contribute to treatment recidivism and how best to minimize them from the perspectives of these adolescents, and (iii) to describe their interaction with the medical culture.
  
  
  METHODS
  A focused applied medical ethnography was used to study 16 purposively selected adolescents. Interviews were conducted together with unobtrusive unit observation of the participants and collection of demographic and clinical information.
  
  
  RESULTS
  The participants were nearly unanimous in identifying the "additional stressors" of problematic parental relations and school bullying as the main triggers of treatment recidivism over and above their "routine stressors" of adolescence and mental illness. They had mixed perceptions of treatment recidivism and described their interaction with the medical culture as positive.
  
  
  CONCLUSIONS
  Further research is needed to determine the impact of parental relations and school bullying on recidivism in adolescents with mental illness.
authors.affiliation: School of Nursing, Health Science Center at Houston, University of Texas, Houston, TX, USA.
authors.forename: Chukwudi C
authors.initials: CC
authors.lastname: Ekwemalor
authors.affiliation: School of Nursing, Health Science Center at Houston, University of Texas, Houston, TX, USA.
authors.forename: Cathy L
authors.initials: CL
authors.lastname: Rozmus
authors.affiliation: School of Nursing, Health Science Center at Houston, University of Texas, Houston, TX, USA.
authors.forename: Joan C
authors.initials: JC
authors.lastname: Engebretson
authors.affiliation: School of Nursing, Health Science Center at Houston, University of Texas, Houston, TX, USA.
authors.forename: Marianne T
authors.initials: MT
authors.lastname: Marcus
authors.affiliation: School of Nursing, Health Science Center at Houston, University of Texas, Houston, TX, USA.
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Casarez
authors.affiliation: Department of Psychiatry and Behavioral Sciences, John P. McGovern Medical School at Houston, University of Texas, Houston, TX, USA.|University of Texas-Harris County Center Psychiatric Hospital, Houston, TX, USA.
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Harper
mesh_terms: D000293:Adolescent; D000884:Anthropology, Cultural; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D028642:Persons with Psychiatric Disorders / Q000523:psychology*; D010359:Patient Readmission; D012008:Recurrence
keywords: adolescents; mental disorder; perceptions; risk factors; treatment recidivism