Home-based psychiatric hospitalization for children and adolescents during war times

Home-based psychiatric hospitalization (HBPH) has gained traction as a flexible alternative to inpatient care for adolescents with complex psychiatric conditions, but little is known about its feasibility when implemented rapidly during national crises. This retrospective study examined clinical outcomes and parental experiences following an emergency transition to HBPH during the Iran-Israel war. The sample included 22 adolescents (91% female, M_age = 15.15) with eating and other psychiatric disorders who were receiving care in inpatient or day hospital settings. Due to the two-week conflict, all participants were transitioned to a structured HBPH model combining remote clinical interventions (e.g., psychotherapy, psychiatric monitoring, nutritional support) with active parental involvement and local medical follow-up. Outcomes were assessed using clinician-rated (CGI-S, CGI-I), patient-reported (EDE-Q13), and parent-reported measures of self-efficacy, satisfaction, and treatment effectiveness. Results showed no clinical deterioration and moderate improvements in symptom severity and BMI. Parental self-efficacy was significantly associated with lower symptom burden and better clinical outcomes. While parents reported high satisfaction with the support provided by the clinical team, some expressed reservations about the broader applicability of the model, likely influenced by the sudden transition to home-based care. These findings suggest that HBPH, when supported by structured guidance and strong caregiver involvement, can be an effective alternative to institutional care even under emergency conditions. Moreover, the results highlight parental self-efficacy as a key therapeutic mechanism that may enhance treatment outcomes. This study adds to the growing evidence base supporting family-centered care models and offers insights for emergency mental health service planning.