Treatment Outcomes of an Adolescent Intensive Outpatient Program for Depressed and Suicidal Youth

Intensive outpatient programs (IOPs) provide an intermediate level of care for high-risk youth and were required to rapidly pivot to telehealth services amid the COVID-19 pandemic. This article aimed to compare symptom outcomes among adolescents treated in IOPs before vs during the pandemic and during the latter period to examine outcomes among adolescents who attended in-person vs via telehealth IOPs.

Depressed adolescents recommended for IOPs between December 2014 and April 2022 (N = 1,152) completed validated self-reports throughout treatment. Patients treated during the pandemic completed treatment in person, via telehealth, or a combination of both. Mixed-effects models were used to examine changes in symptoms over time in treatment.

Compared with pre-pandemic patients (n = 828), adolescents who presented for treatment after the pandemic onset (n = 324) reported increased depression, anxiety, and nonsuicidal self-injury (ps ≤. 006) at intake. Adolescents treated in IOPs (n = 855) demonstrated significant improvement over each week in treatment (ps < .001) across measures of depression (b = -0.79, 95% CI [-0.88, -0.71]), suicidal ideation and behavior (odds ratio = 0.59, 95% CI [0.55, 0.62]), and nonsuicidal self-injury (odds ratio = 0.51, 95% CI [0.46, 0.56]). Significant interactions between time and patient cohort indicated that the slopes of improvement for all outcomes were steeper during the pandemic (ps < .001). There were no differences in improvement of depression, suicidal thoughts and behaviors, or nonsuicidal self-injury for in-person vs telehealth treatment during the pandemic.

These findings indicate similar treatment response to both IOP treatment modalities for suicidal adolescents. Future research should discern factors leading to faster response after the pandemic onset.