Factors affecting readmission of adolescent mental healthcare users to a psychiatric hospital

Abstract

BACKGROUND : Adolescent mental illness is increasing worldwide, leading to more admissions to psychiatric institutions. Many adolescents may require multiple readmissions, which is disruptive to their holistic well-being and costly for the healthcare sector. Identifying especially modifiable risk factors for readmission remains an important step in providing potential areas for improving patient care. AIM : This study investigated the risk factors associated with the readmission of adolescent mental healthcare users to a specialist psychiatric unit. SETTING : The specialist adolescent unit at Weskoppies Psychiatric Hospital. METHODS : In this retrospective study, the clinical files of 345 adolescents admitted between 2015 and 2019 were reviewed. The primary outcome variable was readmission, that is, whether a patient was readmitted to Weskoppies Hospital (n = 98) compared to those with no recorded readmission (n = 247). RESULTS : Readmitted adolescents were significantly younger on first admission compared to the non-readmitted group (13.46 vs 14.26, p = 0.016). Bivariate analysis showed that the readmitted group had a much higher rate of non-adherence to treatment (38.1% vs 10.5%, p = < 0.001). Patients with a family history of mental illness had a significantly higher risk of readmission (52.2% vs 37.5%, p = 0.015). CONCLUSIONS : Adolescents were more likely to be readmitted if they had first admission at a younger age, a family history of mental illness or non-adherence to treatment. CONTRIBUTION : Identifying especially modifiable risk factors for readmission of adolescents to improve patient care, particularly in the South African context where there is a paucity of research on this topic.