Stephanie L Greenham1, Joseph Persi2. 1. Children's Hospital of Eastern Ontario, Ottawa, Ontario. 2. North Bay Regional Health Center, Sudbury Campus, Sudbury, Ontario.
Abstract
OBJECTIVE: Little is known about inpatient psychiatry settings and the services they provide for children and adolescents in Ontario. This paper provides the first broad description of unit characteristics, services provided, and patient characteristics in these settings. METHOD: Nominated representatives from Ontario hospitals with generic mental health beds (i.e., providing inpatient care across diagnostic groups) for children and adolescents were surveyed regarding data from April 2009 to March 2010. Response rate was 93%. Additional data were extracted from the Ontario Network of Child and Adolescent Inpatient Psychiatry Services (ONCAIPS) Directory and Ministry of Health and Long Term Care (MOHLTC) website. RESULTS: Settings provided primarily crisis services with some planned elective admissions. Higher rates of involuntary admissions, briefer stays, lower interdisciplinary diversity, and lower occupancy were typical of settings with higher proportions of crisis admissions. Services most commonly provided included stabilization, assessment, pharmacotherapy, and mental health education. Bed numbers provincially, beds per staff, and prominence of suicide risk, mood disorders, and utilization of cognitive and behavioural approaches were comparable to trends internationally. Inter-setting disparities were observed in access to inpatient services for different age and diagnostic groups, and availability of psychiatry and different professions. CONCLUSIONS: Lack of consistent performance and outcome evaluation, common measures, availability of psychiatry and interdisciplinary supports, and dissimilar treatments provincially, suggest the need to consider potential improvements through systematic monitoring of setting performance and outcomes, and development of provincial best practice standards for staffing and treatment.
OBJECTIVE: Little is known about inpatient psychiatry settings and the services they provide for children and adolescents in Ontario. This paper provides the first broad description of unit characteristics, services provided, and patient characteristics in these settings. METHOD: Nominated representatives from Ontario hospitals with generic mental health beds (i.e., providing inpatient care across diagnostic groups) for children and adolescents were surveyed regarding data from April 2009 to March 2010. Response rate was 93%. Additional data were extracted from the Ontario Network of Child and Adolescent Inpatient Psychiatry Services (ONCAIPS) Directory and Ministry of Health and Long Term Care (MOHLTC) website. RESULTS: Settings provided primarily crisis services with some planned elective admissions. Higher rates of involuntary admissions, briefer stays, lower interdisciplinary diversity, and lower occupancy were typical of settings with higher proportions of crisis admissions. Services most commonly provided included stabilization, assessment, pharmacotherapy, and mental health education. Bed numbers provincially, beds per staff, and prominence of suicide risk, mood disorders, and utilization of cognitive and behavioural approaches were comparable to trends internationally. Inter-setting disparities were observed in access to inpatient services for different age and diagnostic groups, and availability of psychiatry and different professions. CONCLUSIONS: Lack of consistent performance and outcome evaluation, common measures, availability of psychiatry and interdisciplinary supports, and dissimilar treatments provincially, suggest the need to consider potential improvements through systematic monitoring of setting performance and outcomes, and development of provincial best practice standards for staffing and treatment.
Authors: Jonathan Green; Brian Jacobs; Jennifer Beecham; Graham Dunn; Leo Kroll; Catherine Tobias; Jackie Briskman Journal: J Child Psychol Psychiatry Date: 2007-12 Impact factor: 8.982
Authors: Ketil Hanssen-Bauer; Sonja Heyerdahl; Trond Hatling; Gunnar Jensen; Pål Marius Olstad; Tormod Stangeland; Tarje Tinderholt Journal: Int J Ment Health Syst Date: 2011-01-06