To address this gap, this scoping review aims to explore literature on interventions that facilitate discharges from inpatient CAMHS.

A recent scoping review identified discharge planning as a core component of transitions from CAMHS, yet there is limited literature reviewing the components of interventions facilitating successful discharges from inpatient CAMHS and whether current interventions are effective. Systematic reviews examining transitional interventions or discharge planning from inpatient to outpatient settings have limited their inclusion criteria to the adult population (> 18 years old) or have focused primarily on interventions taking place in vocational or educational settings. However, the effectiveness of these interventions has not been extensively described or evaluated in the child and adolescent mental health care services (CAMHS). Discharge interventions have been evaluated to some extent in both child and adult inpatient and outpatient settings. hospital staff, community workers, service providers) that aim to prevent or solve anticipated problems in subsequent outpatient or post-discharge care, facilitate continuity of care, and reduce adverse events post-discharge. Collectively, these findings suggest an urgent need to examine interventions to reduce readmissions and support youth in the post-discharge period.ĭischarge interventions are defined as single or multifaceted interventions involving personal contact between the patient and their care team (i.e. The 30-day unplanned readmission rate for children with a mental health presentation has been calculated to be higher (8%) for those with a non-mental health presentation (6.2%). Readmission rates for children and youth have been shown in the literature to range from 12–65% in the year following discharge. Readmission may reflect the quality of inpatient care, discharge planning, and aftercare provided in the mental health care system. Inpatient psychiatric admission can pose considerable stress for the patient and their family, and readmissions can introduce further personal and health care costs. Inadequate discharge practices can contribute to disjointed care coordination, greater risk of relapse, and poorer patient health outcomes. Existing research has shown preventable adverse events, risk of suicidality, and readmissions are heightened during the post-discharge period. In the United States, pediatric mental health admissions have increased approximately 50% in the past fifteen years and a doubling of emergency department visits related to suicidal attempts and suicidal ideation among youth during 2007–2015. These risks may be even more pressing for the pediatric age group, a demographic more likely to experience the onset of mental illness than any other age group. There is a need for further research into the design, implementation, and evaluation of interventions to support successful discharges from inpatient child and adolescent mental health care.ĭischarge from psychiatric inpatient care can be a time of vulnerability for patients due to the complexity of instructions, transitions between care providers, and shifts in responsibility of those involved. However, findings are limited by inadequate reporting and heterogeneity across studies. Literature on discharge interventions from inpatient CAMHS, while variable in structure, consistently underscore the role of such interventions in minimizing patient and family vulnerability post-discharge. Reported outcomes of discharge interventions were also extracted and included positive patient and caregiver satisfaction, improved patient health outcomes, and increased cost effectiveness. Results of this scoping review found that intervention elements included aspects of risk assessment, individualized care, discharge preparation, community linkage, psychoeducation, and follow-up support. Discharge interventions were extracted and summarized for pre-discharge, post-discharge, and bridging elements. Nineteen documents were included in the final review. This scoping review aimed to describe key components, designs, and outcomes of existing discharge interventions from CAMHS. As such, a scoping review was conducted to identify the literature on discharge interventions. However, there is limited understanding of the structure and effectiveness of interventions to facilitate discharges from CAMHS.

Poor discharge practices and discontinuity of care can put children and youth at heightened risk for readmission, among other adverse outcomes. The post-discharge period is an extremely vulnerable period for patients, particularly for those discharged from inpatient children and adolescent mental health services (CAMHS).

Sample discharge letter from hospital