Follow-up care after psychiatric hospitalization improves outcomes and prevents readmission
Children and adolescents who have been discharged should receive follow-up with a mental health provider within 30 days and ideally within 7 days. Unfortunately, only 54% of Illinois minors covered by Medicaid receive this recommended follow-up(1). Often discharge plans will include an appointment with the primary care physician while the child awaits outpatient mental health care.
When faced with the difficult task of caring for a patient post-psychiatric hospitalization, Illinois DocAssist offers the guidance that you need. You can even schedule regular follow-up calls to help you with medications, therapeutic issues, referrals and more.
Care tips for pediatric patients following psychiatric hospitalization
- Coordinate Care. Obtain discharge paperwork from the patient’s family or contact the discharging hospital to discuss the plan. Ask families to sign consent for you to speak with the referred psychiatric service person or agency.
- Assess and monitor for safety. Assess for continued safety by conducting a suicide screen. Review an existing safety plan or create one if necessary and include the child’s parent or caregiver in this discussion.
- Continue Medication Management. Avoid discontinuing any psychiatric medications abruptly and educate parents on the importance of careful monitoring and adjustments. If you have concerns about continuing prescriptions of polypharmacy or controlled substances, prescribe only a limited supply until a plan can be made with the guidance of an Illinois DocAssist consultant.
- Provide anticipatory guidance. Explain to patients and their families about the wait times for psychiatric outpatient services and encourage them to keep all scheduled psychiatric appointments. Include a discussion about how therapy and psychotropic medications take time to work. Therapy is often the first line of treatment. With regular attendance to therapy and with daily compliance taking medication compliance, improvement occurs faster. Illinois DocAssist Social Workers can assist in locating mental health treatment resources.
- Maximize use of strategies. Encourage the use of coping strategies learned during hospitalization with a caregiver’s support. Research has shown that exercise, adequate sleep, and good nutrition, can help alleviate symptoms associated with depression, anxiety, and other mental health issues.
- Support school advocacy. Encourage the parent to advocate for their child in the school setting to ensure that needs are being met post-discharge. It may be helpful to write a letter to the school as the child’s healthcare provider discussing the child’s hospitalization, diagnosis and the importance of accommodations post-discharge. Some supports and accommodations to support students upon their return to school may include individual counseling, on-site tutoring, support with time management, a universal pass to see a counselor, flexibility in the time of arrival and departure from school, and extended academic completion deadlines(2). For assistance in working with schools and steps to help families advocate for services, contact Illinois DocAssist
References1) Mathematica analysis of Medicaid and CHIP Program System (MACPro) reports for the Child Core Set FFY 2020 reporting cycle as of June 18, 2021 2) Marraccini ME, Pittleman C, Toole EN, Griffard MR. School Supports for Reintegration Following a Suicide-Related Crisis: A Mixed Methods Study Informing Hospital Recommendations for Schools During Discharge. Psychiatr Q. 2022 Mar;93(1):347-383.
