Inpatient Mental Health Care for Your Child: What You Need to Know
The following blog was sponsored by Clarity Child Guidance Center; however, it is NOT about the treatments provided at Clarity. For information about Clarity's services, please visit their website or call 210-616-0300.
If your child’s doctor or therapist has recommended inpatient mental health treatment for your child, you likely have a lot of questions that need answering. In the absence of personal exposure to inpatient mental health care, you may be left with images of dramatic media portrayals that oftentimes do not reflect real life.
To set the record straight about the reality of inpatient hospitalization for your child, here are the 5 W’s of inpatient hospitalization:
1. What Is Inpatient Treatment?
Inpatient treatment involves hospitalization in order to stabilize an individual (in this case your child), which is done through medication management, provided structure, and close monitoring. Stabilization is the primary goal so that your child can then be discharged to more appropriate continued care, which is often outpatient care (although it could involve long-term residential care).
It is important to know that with stabilization as the priority treatment for inpatient care, your child’s underlying presenting problems will not be “cured.” Generally, inpatient treatment involves:
- Daily medical check-ins
- Distribution of prescribed medication
- Therapeutic groups often focused on general healthy coping skills
- Possible additional supplemental structured time with art therapy, music therapy, or animal therapy
Your child will probably not receive much individual therapy in this setting, as the primary goal is to stabilize and move toward discharge for continued treatment and care where individual treatment is more appropriate. For children, at least one family session typically takes place in order to assist with the transition back into the home setting and to create an appropriate care plan.
Most hospital programs do provide some sort of continued academic work. In my professional experience, I have coordinated with inpatient programs that were connected with the credit recovery system used by the local school districts. This would allow your child to continue with their schoolwork through online modules that are honored upon their return to school. I have also coordinated with hospitals that provided academic support and structured time. This would allow your child to work on assignments that you are able to obtain directly from your child’s school.
2. Why Is Inpatient Treatment Used?
Types of mental health care that often occur before inpatient care is considered include:
- Periodic outpatient treatment (often weekly for therapy and may be less frequent for medication management)
- Intensive outpatient treatment (often a daily program for a number of weeks)
When these and other options have been considered or utilized and deemed not appropriate or beneficial, inpatient hospitalization is often the next step. Inpatient treatment is often recommended in the following instances:
- The presence of mental illness or serious emotional disturbance (can include alcohol and drug dependence)
- Experiencing a significant mental health emergency that poses an imminent risk for serious harm to self and/or others
- Significant difficulty functioning in important areas of life, such as at school and in relationships with others
- Needs a higher level of care and treatment because of the mental illness or emotional disturbance (may be experiencing severe symptoms, such as mania, hearing voices, seeing things that are not there, or other psychotic symptoms)
Residential treatment is another type of inpatient mental health treatment, and while this does involve living at a facility, it usually offers a more “home-like” environment, monitoring is not 24/7, the care is often provided over the course of one or more months, and the facility is not in a hospital setting.
3. Who Can Benefit From Inpatient Hospitalization?
Anyone experiencing a mental health crisis who cannot be safely and appropriately addressed in outpatient treatment can benefit from inpatient treatment.
According to the American Psychiatric Association and CDC, one in five children experience serious mental illness in the U.S. Of those children, most will not require inpatient treatment; however, if the above-mentioned mental health conditions are occurring, it may the best route to help a child regain stability in order to safely and more effectively work toward their mental health goals.
It is important to note that patients can voluntarily seek inpatient treatment or may be involuntarily committed to treatment when necessary.
4. Where Does Inpatient Treatment Happen?
Inpatient treatment is generally provided within a private or public hospital setting. The care could be given within a single unit within a larger hospital system or at a specialty hospital for mental health needs.
Inpatient units are secured and provide 24/7 monitoring. In fact, due to the nature of acute crisis, they are quite restrictive in regard to what children can have with them while on the unit, when they are able to have visitors, and how their time is spent throughout the day. Due to the nature of acute and serious mental health crisis, the inpatient hospital setting can be overwhelming and feel scary due to the restrictions, environment, and witnessing other children experiencing variations of mental health crises.
It is also important to note the unfortunate truth in our country: We have a shortage of inpatient hospital beds, especially for children. While true in both the private and public sector, the greatest shortage does exist within public hospital settings. In fact, the APA estimates that “95% of the public psychiatry beds available in 1955 were no longer available as of 2005.”
Due to limited resources, children often face longer-than-recommended wait times at emergency rooms before an available bed at a hospital can be located, and they often must be transported far distances from home to other cities and counties in order to obtain the next available bed. Uninsured and undocumented children are most impacted by these lack of resources.
5. When Does a Child or Adolescent Return From Inpatient Care?
The length of hospitalization for your child will depend on their unique needs. Generally, inpatient care lasts between two days to two weeks. Remember that the primary goal is establishing the stabilization required in order to safely transition your child to a less restrictive treatment setting that can provide longer-term and targeted care.
The hospital medical staff works to ensure that prescription medications provided are helping reduce serious and acute symptoms, monitoring to ensure there are not serious adverse side effects, and working to decrease the imminent risk that may have been presenting at time of admission. Lastly, they are tasked with creating a discharge and continuation of care plan that helps ensure your child is able to receive appropriate follow-up care with an outpatient provider or, when appropriate, be transferred to a residential treatment center.
It is important to know that the inpatient hospital experience will generally only help stabilize your child’s most severe symptoms. The difficulties that you may have observed prior to their inpatient stay may still be present upon their return. Your child will likely continue to need mental, emotional, social, and academic supports in order to improve their mental health and well-being.
The experiences of undergoing inpatient care can be very scary for a child, and the adjustment back into the home and school could be difficult with possible additional feelings of anger, embarrassment, or shame. It’s important for you to provide continued, strong support for your child when they return home. Let them know you are there to help them at any time, follow the mental health care provider’s instructions closely, and coordinate with school administration to make your child’s transition back to the classroom more effective.
Venée M. Hummel, LCSW is a clinical social worker and clinician at the Steven A. Cohen Military Family Clinic at Centerstone in Clarksville, Tennessee, and an instructor at the Garland School of Social Work at Baylor University. She provides clinical services to veterans and military-connected family members, with a specialty focus on evidence-based treatments for posttraumatic stress disorder, suicide prevention, and the impact of deployments on children, couples, and the entire family. She previously completed a fellowship in combat trauma research, assessment, and intervention at the STRONG STAR Research Consortium and Consortium to Alleviate PTSD at Fort Hood, Texas. Ms. Hummel is also the proud daughter of a U.S. Army soldier with over 30 years of active-duty service, and she is honored to dedicate her career to giving back to the community that helped raise her.
The opinions, representations, and statements made within this guest article are those of the author and do not necessarily reflect those of One in Five Minds or Clarity Child Guidance Center. Any copyright remains with the author, and any liability with regard to infringement of intellectual property rights remain with them. One in Five Minds and Clarity Child Guidance Center accepts no liability for any errors, omissions, or representations.