The impact of COVID-19 on adolescent psychiatric inpatient admissions.

COVID-19 has disrupted the lives of individuals and families across the globe. For many, the impacts of this global pandemic have been insurmountable and have resulted in significant stressors. Although medical advances have allowed individuals to slowly begin to restore their sense of normalcy, COVID-19 has resulted in unprecedented mental health impacts for many, especially children and adolescents. The present study examines whether stressors related to COVID-19 and whether subsequent quarantine/isolation were possible contributors to psychiatric crises that led to adolescent psychiatric inpatient admissions. Electronic medical records of those admitted to Strong Memorial Hospital's Child and Adolescent Inpatient Unit between March 13, 2020 and January 1, 2021 were reviewed. Admission and discharge notes were analyzed to determine the presence and context of keywords related to COVID-19. Approximately, 53% of all adolescent psychiatric crises that led to inpatient admission were related to COVID-19 stressors. Results of this study will be used to help understand the extraordinary mental health impacts of a global pandemic and will assist mental health service leaders to better plan for patient flow should there be another wave of quarantine/isolation. Additionally, these results can help inform and develop pandemic-related strategies and interventions that can reduce overall distress in children and adolescents.

Mindfulness-based group therapy: Impact on psychiatrically hospitalized adolescents.

The practice of mindfulness has long been incorporated into psychotherapy. Research on the therapeutic benefits of mindfulness exists within adult populations, and emerging empirical evidence demonstrates the benefit of such practices in the treatment of adolescents in both clinical and non-clinical settings. However, there are extremely limited data on the practice of mindfulness with adolescents in a psychiatric hospital. The iMatter ( Improve Mindful ATTention, Enhance Relaxation) group is a manualized program developed to provide adolescents on a short-term psychiatric inpatient unit with an opportunity to learn and practice relaxation strategies, mindfulness exercises, and simple yoga poses. Mindfulness skills are taught in the context of the group and include self-observation of thoughts and feelings, breathing exercises, self-validation of one's experience, loving-kindness toward self, non-judgmental stance toward self, and acceptance and observation of change within self. Participants included 65 adolescents aged 13-17 years ( M = 15.06, standard deviation ( SD) = 1.34) who took part in at least one session of the iMatter intervention. Improvements in self-reported mood were evident following participation in a mindfulness group. Also, participants' heart rate significantly decreased following participation in two groups. Future directions include improved integration of mindfulness into the milieu and other unit programming. Furthermore, comparing self-reported mood and physiological measures from this sample to findings obtained for other unit groups will further clarify the impact of the iMatter intervention.

Innovative Strength-Based Care in Child and Adolescent Inpatient Psychiatry.

PROBLEM: Child and adolescent psychiatric units serve the highest risk, most vulnerable populations in the mental health delivery system. This article describes the integration of a strength-based approach with a traditional, medical model of psychiatric care on an acute inpatient unit. A strength-based framework allows for increased focus on exploring patients' goals, strengths, relationships, skills, and family communication within the hospital setting. METHODS: The process of integration of strength-based care is described, followed by discussion of the implementation and evaluation of interventions, including mindfulness, family movie, narrative, and animal-assisted therapies. FINDINGS: Innovative interventions led to improvement in patient symptoms, unit culture, and patient, family, and staff satisfaction. CONCLUSION: A strong emphasis on strength-based, multidisciplinary treatment has enhanced patient care, as the goals of acute inpatient admission are broadened to include more than diagnosis and medication management.