A description of 200 consecutive admissions to an adolescent male treatment unit

The objective of this study is to characterize patients admitted to a mental health Adolescent Male Treatment Unit (AMTU) over an 18-month interval.

The study is a cross-sectional retrospective chart review. Data concerning medication management was abstracted along with age, psychiatric diagnoses, degree of impairment, length-of-stay (LOS), and episodes of locked seclusion/restraint.

Two hundred consecutive admissions were analyzed. It was common for a patient to be receiving multiple psychiatric medications. Multiple psychiatric diagnoses were the rule, and externalizing disorders were very frequent. Based on LOS, 4 distinct categories emerged. Patients in Categories I and II accounted for two-thirds of admissions to AMTU and had an LOS of 2 weeks or less. Patients in Category III and IV were one-third of admissions, were more ill, needed locked seclusion/restraint, and required a longer LOS to stabilize and treat them. Treatment tended to include a reduction in the number of psychiatric medications previously prescribed.

The majority of patients could be stabilized and discharged in 2 weeks or less. A minority required more intensive intervention including a long LOS. Receiving multiple psychiatric medications may not be of benefit for some patients. Psychiatric medications may induce behavioral adverse effects in at least a subset of patients.