Institutionalizing Children and Adolescents in Private Psychiatric Hospitals

By Eamon, Mary Keegan | Social Work, September 1994 | Go to article overview

Institutionalizing Children and Adolescents in Private Psychiatric Hospitals


Eamon, Mary Keegan, Social Work


Admission rates of children and adolescents to psychiatric hospitals have been increasing since 1920 and have increased rapidly in recent years. Weithorn (1988) analyzed data from the National Institute of Mental Health (NIMH) that showed a 15 percent increase in admissions during the 1970s. Darnton (1989) found that between 1980 and 1986 psychiatric admissions of people younger than 18 increased by more than 36 percent.

Privately owned psychiatric hospitals have accounted for the most recent increases in admissions of children and adolescents. Public hospitals, in contrast, have had declining admissions. During the 1970s, private hospital admissions of children and adolescents increased from 37 percent of the total admissions to 61 percent (Weithorn, 1988). Between 1980 and 1986 admissions of children and youths to private psychiatric hospitals increased 60 percent (Darnton, 1989).

Is the increased use of private institutions consistent with current theory and research about what constitutes the most appropriate mental health treatment for children and youths? Are these accelerating admissions justified by the admitting diagnoses? Are they effective in terms of treatment outcome and cost?

This article discusses reasons for continued high rates of institutionalization of children and adolescents, including changes in juvenile justice law, insurance practices, lack of legal protection for children and youths, inappropriate government policies, and the increase in for-profit hospitals.

Evaluation of Increased Use of Psychiatric Hospitals

Appropriateness for Youths

Current theory and empirical research stress that the problems of children and youths reflect the interactions between intrapsychic difficulties and the child's environment, including family, school, home, and community. Multiple government and advocacy group investigations into the mental health treatment of children and adolescents have come to similar conclusions. If children and youths are to be treated effectively, their problems must be dealt with in a coordinated way within a variety of community-based settings (Inouye, 1988; Saxe, Cross, & Silverman, 1988; Tuma, 1989).

The increased use of psychiatric hospitalization as a form of mental health treatment for children and adolescents is not consistent with these conclusions. Hospitalization removes the child from his or her environment, identifies the child as the patient, and in most instances focuses treatment on the child or adolescent. Hospitalization inherently makes it difficult to deal effectively with the individual's problems within the variety of systems in which the child or adolescent must interact and, in most cases, to which the child will ultimately return.

During the past two decades inpatient facilities for children and adolescents have placed more emphasis on incorporating the family and other social systems into the patient's treatment plan. Formerly, many family therapists were reluctant to even legitimize hospital treatment for families as constituting "family therapy" because of the separation and designation of a family member as the patient (Hanrahan, 1986). Today, most authorities on the psychiatric hospitalization of children agree that some type of collaborative work with families is necessary for successful treatment, and there is some empirical evidence to support this (Jemerin & Philips, 1988). In addition to family therapy, approaches involving the family within the hospital setting have included individual therapy with each family member, intensive collateral work, hospitalization of the mother or the entire family along with the child (Jemerin & Philips, 1988), parent training programs, and parent support groups (Dalton, Muller, & Forman, 1988).

The treatment perspective of the transactional risk model advocated by Woolston (1989) is perhaps the most consistent with the current view on child and adolescent mental health problems. …

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • A full archive of books and articles related to this one
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Institutionalizing Children and Adolescents in Private Psychiatric Hospitals
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

    Already a member? Log in now.