A continuum of mental health care for children and adolescents

As an alternative to the confusing patchwork that often characterizes child and adolescent mental health care, the mental health program of a children's social welfare agency offers a continuum of inpatient and outpatient services on one campus. The program operates a 36-bed psychiatric hospital, a 38-bed residential treatment program, a partial hospital for ten children and adolescents, and a large outpatient service, and it can draw on the agency's foster care, emergency shelter, and home-based therapy services. Treatment in all the services is provided by multidisciplinary treatment teams, which have primary responsibility for coordinating a patient's transfer with other elements of the continuum and for initiating a patient's discharge. A case study illustrates some of the practical considerations that influence treatment decisions in the continuum.