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date: 22 January 2019

Abstract and Keywords

Inpatient treatment of children and adolescents forms an important part of modern psychiatric care. The place of residential treatment has changed: First, effective evidence-based community treatments are now more readily available; at the same time, the increasing recognition of youth mental illness has led to greater demands for admission. Admission of more suicidal adolescents with higher complexity and greater levels of violence and self-harm has resulted in a complex inpatient environment. Second, there is a drive for shorter admissions, partly driven by costs and resource limitations. The running of residential services is a complex activity, and understanding the group dynamics and careful integration of multiple therapeutic modalities by a multidisciplinary team is important to any successful outcome. There are specialized services, including eating disorder, forensic/secure, learning disability, and autism units. The outcome of inpatient care is favorable, although costly, and crucially requires managed integration with outreach and community psychiatric services.

Keywords: inpatient treatment, evidence-based treatment, medication, psychiatry, discharge, residential services, group dynamics, multidisciplinary team

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