Nev Jones1, Becky K Gius2, Morgan Shields3,4, Shira Collings5, Cherise Rosen6, Michelle Munson7. 1. Department of Psychiatry and Behavioral Neurosciences, University of South Florida, 4202 East Fowler Ave, Tampa, FL, 33620, USA. genevra@usf.edu. 2. Department of Psychology, University of South Florida, Tampa, FL, USA. 3. Department of Psychiatry, Center for Mental Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. 4. Leonard Davis Institute of Health Economics, Philadelphia, PA, USA. 5. Department of Counseling, Troy University, Tampa, FL, USA. 6. Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA. 7. Silver School of Social Work, New York University, New York, NY, USA.
Abstract
PURPOSE: Few studies have focused on the experience of involuntary psychiatric hospitalization among youth, especially the impact of these experiences on engagement with mental health services post-discharge. In this study, we contribute to a deeper understanding of youth experiences of involuntary hospitalization (IH) and its subsequent impacts on trust, help-seeking, and engagement with clinicians. METHODS: The study utilized a grounded theory approach, conducting in-depth interviews with 40 youth and young adults (ages 16-27) who had experienced at least one prior involuntary hospitalization. RESULTS: Three quarters of the youth reported negative impacts of IH on trust, including unwillingness to disclose suicidal feelings or intentions. Selective non-disclosure of suicidal feelings was reported even in instances in which the participant continued to meet with providers following discharge. Factors identified as contributing to distrust included perceptions of inpatient treatment as more punitive than therapeutic, staff as more judgmental than empathetic, and hospitalization overall failing to meet therapeutic needs. Conversely, participants reporting more mixed experiences of hospitalization and simultaneously strong indirect benefits, including greater family support, diminished family judgement members and greater access to care. CONCLUSION: Findings draw attention to the ways in which coercive experiences may impact youth pathways to and through care. Additional research is needed to understand the impact of these experiences across larger samples, and their influence on downstream outcomes including engagement and long-term wellbeing. Finally, these data may inform the development and testing of inpatient and post-discharge interventions designed to mitigate potential harm.
PURPOSE: Few studies have focused on the experience of involuntary psychiatric hospitalization among youth, especially the impact of these experiences on engagement with mental health services post-discharge. In this study, we contribute to a deeper understanding of youth experiences of involuntary hospitalization (IH) and its subsequent impacts on trust, help-seeking, and engagement with clinicians. METHODS: The study utilized a grounded theory approach, conducting in-depth interviews with 40 youth and young adults (ages 16-27) who had experienced at least one prior involuntary hospitalization. RESULTS: Three quarters of the youth reported negative impacts of IH on trust, including unwillingness to disclose suicidal feelings or intentions. Selective non-disclosure of suicidal feelings was reported even in instances in which the participant continued to meet with providers following discharge. Factors identified as contributing to distrust included perceptions of inpatient treatment as more punitive than therapeutic, staff as more judgmental than empathetic, and hospitalization overall failing to meet therapeutic needs. Conversely, participants reporting more mixed experiences of hospitalization and simultaneously strong indirect benefits, including greater family support, diminished family judgement members and greater access to care. CONCLUSION: Findings draw attention to the ways in which coercive experiences may impact youth pathways to and through care. Additional research is needed to understand the impact of these experiences across larger samples, and their influence on downstream outcomes including engagement and long-term wellbeing. Finally, these data may inform the development and testing of inpatient and post-discharge interventions designed to mitigate potential harm.
Entities:
Keywords:
Involuntary hospitalization; Suicide prevention: pathways to care; Treatment engagement; Youth and young adults
Authors: Sarah Carter Narendorf; Michelle R Munson; Micki Washburn; Nicole Fedoravicius; Richard Wagner; Sara K Flores Journal: Am J Orthopsychiatry Date: 2016-10-24
Authors: S Opjordsmoen; S Friis; I Melle; U Haahr; J O Johannessen; T K Larsen; J I Røssberg; B R Rund; E Simonsen; P Vaglum; T H McGlashan Journal: Acta Psychiatr Scand Date: 2010-01-19 Impact factor: 6.392