Young children in psychiatric crisis present complex challenges to their families and service providers. This article presents a qualitative study of families’ perspectives on the crisis that led to their child's hospitalization, as well as their experience and satisfaction with prior community-based services including crisis services. Results of the study support the usefulness of an ecological view on child mental health emergencies, and specify the need for the development of a more family-centered, community-based crisis response system that includes secure transportation and access to “warm-line” services. To prevent or curtail hospitalization of children, families require assistance in outpatient medication management, especially timely access to psychiatric medication consults and clear information from professionals about benefits and side effects.
Get full access to this article
View all access options for this article.
References
1.
BlumbergS. H. (2002). Crisis intervention program: an alternative to inpatient psychiatric treatment for children.Mental Health Services Research, 4(1), 1–6.
2.
BurnsB. J., HoagwoodK., & MrazekP. J. (1999). Effective treatment for mental disorders in children and adolescents.Clinical Child and Family Psychology Review, 2(4), 199–254.
3.
EvansM. E., BoothroydR. A., & ArmstrongM. I. (1997). Development and implementation of an experimental study of the effectiveness of intensive in-home crisis services for children and their families.Journal of Emotional and Behavioral Disorders, 5(2), 93–105.
4.
EvansM. E., BoothroydR. A., ArmstrongM. I., GreenbaumP. E., BrownE. C., & KuppingerA. D. (2001). Outcomes associated with clinical profiles of children in psychiatric crisis enrolled in intensive, in-home interventions.Mental Health Services Research, 3(1), 35–44.
5.
EvansM. E., BoothroydR. A., ArmstrongM. I., GreenbaumP. E., BrownE. C., & KuppingerA. D. (2003). An experimental study of the effectiveness of intensive in-home crisis services for children and their families: program outcomes.Journal of Emotional and Behavioral Disorders, 11(2), 93–104.
6.
GeertzC. (1973). The interpretation of cultures: Selected essays. New York, NY: Basic Books.
7.
GutsteinS. E., RuddM. D., GrahamJ. C., & RayhaL. L. (1988). Systemic crisis intervention as a response to adolescent crises: An outcome study.Family Process, 27(2), 201–211.
8.
HenggelerS.W., RowlandM. D., Halliday-BoykinsC., SheidowA. J., WardD. M., RandallJ., PickrelS. G., CunninghamP. B., & EdwardsJ. (2003). One year follow-up of multisystemic therapy as an alternative to the hospitalization of youths in psychiatric crises.Journal of the American Academy of Child and Adolescent Psychiatry, 42(5), 543–551.
9.
HenggelerS.W., RowlandM. D., RandallJ., WardD. M., PickrelS. G., CunninghamP. B., MillerS. L., EdwardsJ., ZealbergJ. J., HandL. D., & SantosA. B. (1999). Home-based multisystemic therapy as an alternative to the hospitalization of youths in psychiatric crisis: clinical outcomes. Journal of the American Academy of Child and Adolescent Psychiatry. 38(11), 1331-1339.
10.
HenggelerS.W., SchoenwaldS. K., RowlandM. D., & CunninghamP. B. (2002). Serious emotional disturbance in children and adolescents—Multisystemic therapy.New York, NY: Guilford.
11.
KutashK., & RiveraV. R. (1995). Effectiveness of children's mental health services: A review of the literature.Education and Treatment of Children, 18(4), 443–477.
12.
LincolnY. S., & GubaE. G. (1985). Naturalistic inquiry. Beverly Hills, CA: Sage.
13.
PetrC.G. & WalterU.M. (2005). Best practices inquiry: a multidimensional, value-critical framework,Journal of Social Work Education, 41(2), 251–267.
14.
PetrC. G. (1994). Crises that threaten out-of-home placement of children with emotional and behavioral disorders.Families in Society, 75(4), 195–203.
15.
PumariegaA. J., & WintersN. C. (2003). Trends and shifting ecologies: Part II.Child and Adolescent Psychiatric Clinics of North America, 12(4), 779–793.
SchoenwaldS. K., WardD. M., HenggelerS.W., & RowlandM. D. (2000). Multisystemic therapy versus hospitalization for crisis stabilization of youth: Placement outcomes 4 months postreferral.Mental Health Services Research, 2(1), 3–12.
18.
SharerK. (2002). What parents of mentally ill children need and want from mental health professionals.Issues in Mental Health Nursing, 23, 617–640.
19.
SilverT., & GoldsteinH (1992). A collaborative model of a county crisis intervention team: The Lake County experience.Community Mental Health Journal, 28(3), 249–256.
20.
StelzerJ. & ElliottC. A. (1990). A continuous-care model of crisis intervention for children and adolescents.Hospital and Community Psychiatry, 41(5), 562–564.
21.
StroulB. A., & GoldmanS. K. (1990). Study of community-based services for children and adolescents who are severely emotionally disturbed.Journal of Mental Health Administration, 17(1), 61–77.
22.
U.S. Department of Health and Human Services (1999). Mental health: A report of the surgeon general. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health. Retrieved July 7, 2005 from http://www.mentalhealth.samhsa.gov/features/surgeongeneralreport/chapter3/sec3.asp.
23.
WalterU. M., DavisS., & PetrC. G. (2005). Final project report: Admission of young children to state hospitals in the Kansas mental health system (Research Monograph). Lawrence, Kansas: School of Social Welfare, University of Kansas. Available online at http://www.socwel.ku.edu/occ/projects/cmh/mhsEvaluations.html#hospitalAdmission.
