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Editorial: Do we need inpatient units?

Gabrielle A Carlson1, Rachel Elvins2

  • 1Department of Psychiatry and Pediatrics, Renaissance School of Medicine at Stony Brook University, New York, NY, USA.

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|April 27, 2021
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Summary

Psychiatric hospitalization for children should be a last resort due to high costs and unnatural settings. Investing in community-based care and aftercare offers a more effective, holistic approach to youth mental health.

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Area of Science:

  • Child and Adolescent Psychiatry
  • Mental Health Services Research
  • Healthcare Policy

Background:

  • Psychiatric hospitalization for youth is expensive and disrupts family/community ties.
  • International experts advocate for reduced reliance on inpatient care for children and adolescents.
  • Limited community resources hinder the development of alternatives to hospitalization.

Discussion:

  • High costs of inpatient stays could fund extensive community-based psychiatric treatment for a year.
  • Lack of well-trained clinicians and resources is a critical barrier to community-based care.
  • Centralized treatment models in higher-income countries stem from an over-reliance on inpatient beds.

Key Insights:

  • There is a global consensus on the need for psychiatric hospitalization to be sparingly used for youth.
  • Resources allocated to inpatient units could be redirected to prevention and aftercare services.
  • Low- and middle-income countries face severe shortages in both inpatient and community mental health resources for young people.

Outlook:

  • Urgent attention is needed to establish comprehensive, community-based mental health services for youth.
  • Integrating preventive services and holistic care is crucial for addressing the mental health needs of young people.
  • Shifting from an over-reliance on inpatient beds towards community-integrated care models is essential for improving youth mental health outcomes.