Inpatient hospitalizations are always a factor with high-risk youths, but they can be reduced.

Behavioral health organizations working with adolescents face numerous challenges. Especially those in a community setting. Federal laws such as the Family First Prevention Services Act focus on keeping youths away from residential facilities. While the emphasis on community settings for troubled youths is a positive trend, it still doesn’t always address how to keep youths safe and away from harming themselves or others.

Foster youth, youths with trauma histories, youths abusing substances and alcohol, and youths with a history of mental health disorders all have a higher propensity to need hospitalization at some point. 

Many live in the revolving door of inpatient care for a brief stabilization, only to be sent back home and then return to the hospital within a few weeks or months. This harms the youth, the family, and the community. Without the consistency the youth need, they see themselves as “dangerous,” “damaged goods,” and unable to control their behaviors.

But reducing hospitalizations is not a daunting task. In fact, with proper skills, training, and plans in place, organizations and staff can keep their high-risk youths out of the hospital and safely at home.  How is this possible?

Here are four ways to reduce adolescent hospitalization:

1.           Involve staff with lived experiences in their treatment. Parent partners immediately make a difference. They get the parent engaged in treatment, and they listen. They’re willing to be active participants rather than passive bystanders. And peer partners help the youth defuse their behavior. Because they understand the crises and emotional fluctuations the youth suffers. These alliances with peer support staff reduce hospitalizations.     

2.           If a youth is on psychotropic medication, make sure they take it. In many instances, medication for youth helps them improve the biochemical imbalance they experience. The anxiety reduces; the moods fluctuate less. In a recent article, researchers indicated that the attitudes and knowledge of youths about the medication they were taking led to higher medication adherence. You've probably seen cases in your agency or with your clients where a parent is told their child needs to take medication. Then the parent either stops the meds because the child complains or doesn’t refill them when they run out.  A few days later, the youth enters the hospital because they can’t control their desire to harm themselves or others. If there are issues with the medications, it’s a discussion for the psychiatrist; not to abruptly stop.

3.           Role play with parents or caregivers and youth the skills they need, as discussed in a recent article. Give the parent and youth tools to calm the youth down. In most instances, when an adolescent is close to endangering their lives or others, the parent is the first one who notices.  They see the signs and symptoms and notice the triggers and the cues. But they feel helpless to stop them because they don’t have the skills. Teaching the parent what to do in crises and how to defuse anger helps the youth to do something soothing rather than aggravating. Talking calmly, and giving them options, defuses the youth's behavior. Examples of role-playing can slow down the emotional responses, offer the youth opportunities to take a break from the stressor, or learn deep breathing techniques.   

4.           Recognize the role trauma plays in hospitalizations. The pain of a trigger or a flashback can activate youth to want to end that pain. Because when people are under stress, they have a fight-or-flight response. Or they want to numb themselves from the pain. This happens with trauma survivors. And if a trigger activates, they can respond with rage towards others or themselves. Staff or parents can help the youth stay with the feeling. Give it a name. Tell the youth the feeling is temporary. Be there with them while they feel it. Give them a soothing option to reduce stress. Slowing down their breathing to six breaths a minute. These skills let them experience the trauma a little at a time and reintegrate it into their mind and body. Lessening its effect in the future.

Learning new skills helps staff and parents deal with youths, keeping them safe at home.

For more information, please contact us.