Teens Are Not Receiving Timely Psychiatric Care after Inpatient Treatment

People who develop psychiatric issues often first exhibit symptoms during adolescence. The number of inpatient mental health care venues for teens has increased dramatically in the past several decades. And although inpatient care is an intensive approach, the length of stay for teens has decreased. This could be attributed to the increased access to outpatient mental health services. But Corine Carlisle, a Clinician Scientist at the Centre for Addiction and Mental Health and an Assistant Professor in the Department of Psychiatry at the University of Toronto in Canada wanted to find out just what percentage of teens actually received follow-up care after inpatient treatment. To determine this, Carlisle interviewed 711 Canadian teens between the ages of 15 and 19 years old who had been released from a mental health facility and asked them if they received aftercare from a primary doctor or specialist in the weeks or days following their discharge.

Carlisle found that although nearly one in four teens did see a primary doctor or mental health professional in the week immediately following discharge, less than half of the teens saw anyone in the month after they left inpatient treatment. Those with higher economic statuses and with mood disorders were much more likely to receive care than those from lower socioeconomic classes. Also, the teens with a history of substance misuse, suicide attempts, or self-injurious behaviors were the least likely to receive follow-up care. And for teens in rural areas, the rates of aftercare were even lower.

The finding of low follow-up among those with substance misuse, self-injurious behaviors, and suicidal ideations could indicate a lower level of engagement, which should be the focus of inpatient care. Carlisle is especially concerned by the results of her study because lack of aftercare could increase a teen’s chance of further symptoms development and future inpatient stays. “Our findings point to significant challenges in the availability, accessibility, and geographic equity of mental health services for youth,” said Carlisle. The cost of mental health care is escalating, and individuals who do not have access to, or who choose not to participate in aftercare could potentially incur significant psychological and financial costs later on.

Carlisle, Corine, Muhammad Mamdani, Russell Schachar, and Teresa To. Predictors of psychiatric aftercare among formerly hospitalized adolescents. Canadian Journal of Psychiatry 57.11 (2012): 666-76. Print.

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  • Bryan.Y


    December 24th, 2012 at 4:13 PM

    In marketing,when a sale is followed by poor servicing, the product faces a backlash. But why are we doing this with our teenagers’ mental health?? Rushing to a facility when there is a problem is one thing,but following up once the person recovers is another. Its like a full course of medication. Follow ups can turn out to be the difference between no recurrence and a relapse.

    The clients need to be made aware of the importance of follow ups and they could also be provided with a reminder service for follow up visits if you ask me!

  • jodie


    December 24th, 2012 at 11:50 PM

    its so easy to return to the former tattered state for a teen suffering from a psychiatric issue.been there and experienced that in my teen years.if not for the continued support of the professionals and family,I do not even want to think about how things could have turned out for me.

    initial care is very important but whats also important is continued supervision and monitoring.if that does not happen and the parents are ill equipped to identify then things can quickly go downhill.

  • alison


    December 25th, 2012 at 11:47 AM

    I’d love to know the reasons for this.Is it the lack of availability,accessibility or a disengagement from the clients themselves?I’ve know a few people who received care and therapy but wanted it to end ASAP because they didn’t want anybody else to know and they wanted to feel ‘normal’.

  • Mike


    December 26th, 2012 at 6:54 AM

    Whoa, now this is something scary to ponder! Think about how much we as adults need follow up care after something significant happens to us, especially if it is inpatient treatment for any psychiatric issues. For teens and younger patients it could be even more critical because most of them have no clue how to ask for the help that they need.

  • Doug


    December 26th, 2012 at 9:33 AM

    my daughter had to go to an inpatient place last spring. it was over spring break so they didn’t have school. all they did was sit arond and play games.

    my daughter tried to kill herself and all they did was sit around and play games.

  • Janice


    December 26th, 2012 at 9:36 AM

    I think it’s just wrong that people in the lower class don’t have the same access to after care as people in the middle class. Who cares what class they are from. They should all have the same chance to get better. Teens can’t help what their parents do for work.

  • jacqueline


    December 26th, 2012 at 11:01 AM

    the families of these teens need to be made aware before the inpatient treatment is done with.they need to know that it is not just an episode that you can be done with.it needs follow up and often times follow up can be the difference between recurrence and complete treatment.

    if they do not know they will obviously take it that the treatment is now over and no further process is needed.that is far from the truth and can in fact causes even more problems than before.



    December 26th, 2012 at 7:02 PM

    Its far tougher to keep going back to outpatient facilities.More than logistics it is a mental thing.So why dont they encourage longer inpatient stays than more number of outpatient visits (most of which are going to be missed anyway) ?

  • Hugh


    December 28th, 2012 at 4:04 AM

    So again we see that the rich get richer and the poor stay poor, but in this case though it seems that the lack of money determines whether or not you will seek treatment for your kid even after they have been in a facility.

    This I don’t get. No matter how much money I do or don’t have, if my kid has been in treatment, then I am getting help for them before and after, and all throughout their stay, and nothing will stop me. There are places that accept Medicaid for this treatment and if that is what I have to resort to then I will do it.

    To not get your child help because of money? Not acceptable. And not acceptable to have a health care system that would allow this and just ignore that there is real need in certain populations and do nothing about it.

  • kelly


    December 28th, 2012 at 3:53 PM

    concerned about the disparity between people of lower and higher socioeconomic statuses..is the difference purely due to their status or due to the knowledge and better guidance that their doctors could provide?

  • Nolan


    December 29th, 2012 at 12:12 PM

    There is definitely some blame to go around in this scenario.
    Where are the parents who need to get these kids to treatment?
    And where are the medical professionals whose job it is to ensure that their patients receive the necessary follow up care?
    And hound them until they do?



    December 29th, 2012 at 2:36 PM

    How many people complete their mess course? How many people continue with therapy soon after they feel better? Not too many I suppose. Unless and until they realize that treatment is a process and not an isolated event they will not begin to see how it works.
    And especially in case of these adolescents half-baked treatment may cause so many problems down the years!

  • Faye


    December 30th, 2012 at 4:46 AM

    For many families the thought of having their child receive in patient treatment is all they can afford. That alone could financially drain them. It may be irresponsible to not seek out after care, but at the same time, we need to make it more affordable for those who need it and would get it if it was within the reach of their finances.

  • Shayne


    December 31st, 2012 at 8:50 AM

    What a shame that our healthcare system is currently set up only for making money and not providing care for these kids.

  • Nicholas


    January 3rd, 2013 at 4:05 AM

    While I agree that is nsome ways the medical profession must do a better job at providing appropriate and critical follow up care for their patients at each stage of their recovery, I don’t think that there are too many of them with the individual resources to track down each and every patient and make sure that they are receiving it. I think that our sysatme has not only put a great deal of stress on patients, but on our providers too. There is truly only so much that one person can do- why is it fair to always point the finger of blame at them when many times they are just doing the best that they can with the situation that they have been given? It is broken in so many ways, that the only way to fix it is one step, one day at a time.

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