https://doi.org/10.1177/1039856219875068
Australasian Psychiatry
1–5
© The Royal Australian and
New Zealand College of Psychiatrists 2019
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DOI: 10.1177/1039856219875068
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1
AUSTRALASIAN
PSYCHIATRY
A
n adolescent inpatient admission is sought for
those with severe behavioural or emotional dis-
turbances, causing major impairment. Despite
attempts to treat adolescents in community settings,
inpatient units remain a frontline treatment option.
This is evident with the increasing demand for adoles-
cent inpatient care.
1
Adolescent inpatient units often provide an effective
approach at least for symptom reduction. A recent inter-
national review of public and private inpatient units
found that adolescents improved in at least one area of
symptomatology from admission to discharge. However,
evidence is limited. The review found only 16 studies
since 2000 with 50% of these conducted over 10 years
ago. In Australia, no studies have been conducted in the
last decade and few describe models of care (MoCs) and
the relationship of these with outcome.
Given the need for early interventions, more research is
warranted to examine adolescent inpatient units and
understand how best to support this group.
1
It is now
recognised that government-funded models such as
‘Headspace’ only serve some young people and are strug-
gling to meet the needs of more complex adolescents.
2
A profile of adolescents admitted
to a private inpatient unit and
mental health outcomes
Claire Hayes Registered Psychiatric Nurse, Department of Psychiatry, The Albert Road Clinic, The University of Melbourne,
Melbourne, VIC, Australia
Magenta Simmons Research fellow, Orygen Youth Health, Centre for Youth Mental Health, The University of Melbourne,
Melbourne, VIC, Australia
Victoria J Palmer Associate Professor, Department of General Practice, The University of Melbourne, Melbourne, VIC, Australia
Bridget Hamilton Associate Professor, Centre for Psychiatric Nursing, The University of Melbourne, Melbourne, VIC, Australia
Christine Simons Medical Director of Adolescent Services, Department of Psychiatry, The Albert Road Clinic, The University
of Melbourne, Melbourne, VIC, Australia
Malcolm Hopwood Professor, Department of Psychiatry, The Albert Road Clinic, The University of Melbourne, Melbourne,
VIC, Australia
Abstract
Objective: To characterise adolescents admitted to a voluntary adolescent inpatient unit and investigate treatment
outcomes.
Method: A retrospective cohort design was employed. Health of the Nation Outcome Scales for Children and Ado-
lescents (HoNOSCA) pre- and post-admission scores were collected, measuring global functioning. Demographic
variables such as age, gender, primary diagnosis, comorbidity and length of stay (LOS) were analysed. Data were
collected from May 2017 to April 2018. All adolescents admitted to the inpatient unit were included.
Results: The majority of adolescents (n = 72; HoNOSCA data available on n = 57) were 16 years of age (26%), female
(82%) and with a primary diagnosis of a mood disorder (57%). Most adolescents improved at the time of discharge.
Self-injury and emotional symptoms had greater reductions according to clinician and adolescent-self-ratings (p <
0.01). Mean change (improvement) in HoNOSCA total score was 7.3 (SD 7.5) based on clinician ratings and 7.2 (SD
9.5) for adolescent-self-ratings. The mean LOS was 28 days (SD 15.8).
Conclusions: The inpatient unit proved effective at meeting the needs of young people in terms of symptom stabilisa-
tion. Further research is needed to describe adolescent inpatient models of care, the operations and philosophies to
better examine how these relate to treatment outcomes.
Keywords: adolescents, mental health, inpatient, outcomes
Corresponding author:
Claire Hayes, Department of Psychiatry, The Albert Road
Clinic and The University of Melbourne, 31 Albert Road,
Melbourne, VIC 3004, Australia.
Email: chayes2@student.unimelb.edu.au
875068APY Australasian PsychiatryHayes et al.
Research Article