Factors Associated With Psychiatric Readmission of Youths in a Racially Diverse and Urban Hospital Setting.

OBJECTIVE: This study examined predictors of readmission to a psychiatric inpatient unit of an urban children's hospital within 1 year of discharge among a racially diverse sample of youths. METHODS: The authors retrospectively analyzed 2 years of electronic health record data of inpatient psychiatric unit admissions (N=1,604). Multivariate logistic regression and random-effects multinomial logistic regression were used for analyses. RESULTS: The estimated odds ratios for any readmission within 1 year of discharge were significantly higher for Black youths, youths insured by Medicaid, and youths with a length of stay longer than 7 days. Factors remained strongly predictive when examining multiple readmissions versus no readmissions. CONCLUSIONS: Black youths, youths insured by Medicaid, and youths with longer stays were more likely than other youths to be readmitted. Findings suggest the need for interventions such as care coordination to target predictors of readmission and the need to examine inequities in the health care system.

Discouraging partnerships? Teachers' perspectives on immigration-related barriers to family-school collaboration.

This study investigates barriers to facilitating family-school partnerships with immigrant families as identified by teachers in an urban school district with high rates of immigration. Participants consisted of 18 elementary teachers who identified predominantly as Hispanic (38.9%) or non-Hispanic White (33.3%), were frequently bilingual (55.6%), and were mostly female (94.4%) with an average age of 36.5 years. Participants engaged in focus group interviews that were transcribed and open-coded. Barriers to engagement for immigrant families fell into 3 broad areas: language and culture, family resources, and families' undocumented status. Many teachers attributed the barriers preventing parental collaboration to school policies (94.4%) and ineffective communication strategies (83.3%). Teachers also identified barriers as emanating from the families themselves, including families not attending school functions (88.9%) and being unresponsive to school-initiated communication (72.2%). Teachers noted that many families lacked resources necessary for school engagement (88.9%) and were hesitant to become engaged with schools due to required screening procedures (55.6%). Overall, numerous barriers to effective family engagement were identified, several of which are directly related to immigration and residency status. Given the strong evidence suggesting that family engagement in education mediates risk for children of recent immigrants, strategies to foster meaningful engagement for all families are desperately needed (Naughton, 2004). Roles for school psychologists to facilitate effective family-school partnerships are discussed. (PsycINFO Database Record