Findings from a recent systematic review by the Children’s Health Policy Centre offer hope for children at risk of being hospitalized.  These findings suggest four implications for practice and policy:

• Reduce mental health hospitalizations safely by supporting children in community. An evaluation of a program known as Home Treatment provides evidence that it is possible to shorten inpatient stays when adequate outpatient supports are provided. Young people with these extra supports had stays that were 21 days shorter compared with regular services without any difference in overall functioning eight months later.

• Recognize that extra supports after hospital discharge can have wide-ranging benefits. A study of a program known as Supported Discharge Service demonstrates it’s possible to reduce the number of children frequently engaging in self-harm, while increasing their engagement in school and other productive activities. These findings suggest that supporting children after hospitalization can yield multiple gains across multiple domains.

• Build on the research evidence to better serve children in rural and remote communities. Supported Discharge Service was delivered in two regions, one of which was rural, showing that it is feasible to provide intensive mental health services even in more remote communities. Using technology to deliver interventions virtually may be another way to reach more children in rural and remote communities. Such delivery is increasingly common since the COVID-19 pandemic began, according to a recent US study of mental health care delivery, which found a twelvefold increase in psychologists’ use of telecommunications such as video calls.

• Support children post-hospitalization knowing that doing so will pay off. The Home Treatment and Supported Discharge Service studies both provide evidence of cost-effectiveness. These findings suggest that any costs associated with providing added supports post-hospitalization are likely outweighed by the benefits. For example, even though the costs of Supported Discharge Service were not significantly lower than regular services, the intervention was still cost-effective when considering the benefits it produced, including reducing self-harm and increasing engagement in productive activities.

The CHPC review suggests that after a mental health hospitalization, young people can be supported to return home more quickly and remain there, with less need for rehospitalization. This review also found that intensive community-based services are cost-effective, enabling children and youth to flourish without the impediment of prolonged or repeated hospitalizations. When these interventions are coupled with adequate investments in programs that address social determinants of mental health as well as effective prevention and treatment programs, fewer children will likely need hospital care for mental health issues.

For more information, see Vol. 16, No. 3 of the Children’s Mental Health Research Quarterly.