Rebecca Marshall, M.D., M.P.H., of the Oregon Health & Science University, and colleagues used data from the Oregon Health Authority’s Crisis and Transition Services (CATS) program. Youth qualified for CATS if they were at risk for boarding in the ED due to safety concerns, severe depression or anxiety, or other mental health concerns that impaired their functioning. CATS provided 24/7 crisis response, crisis safety planning, short-term clinical interventions, and connections to longer-term services. Services lasted for 45 days after enrollment.
The researchers included 533 youth ages 11 to 17 years (69% female) who participated in CATS from 2018 to 2020. Using All Payer All Claims data, each participant was matched with two controls (n=1,066) of the same sex and similar age who had the same reason for an ED or inpatient care visit. One control group included those discharged from an inpatient hospital or psychiatric unit, while the other included those discharged from the ED. Youth in the control groups received either behavioral health treatment that did not include CATS or no treatment at all.
CATS participants were significantly less likely than those who did not participate to return to the ED or require inpatient hospitalization in the year after their initial mental health crisis. While the risk of returning to the ED for a suicide attempt was similar for CATS participants and nonparticipants, the risk of receiving hospitalization for a suicide attempt was significantly lower for those enrolled in CATS.
“This finding suggests that, although CATS may not reduce suicide attempts overall, youths in this program were able to return home rather than be hospitalized in an [inpatient] unit, thereby decreasing the burden placed on EDs to board youths and allowing youths to stay in the community,” the researchers wrote.
“This study suggests that community-based crisis intervention programs with an array of services and that focus on bridging youths to longer-term services may represent a safe and effective alternative to ED boarding for some youths with high-acuity behavioral health needs,” the researchers concluded.
For related information, see the Psychiatric News article “Oregon Pilot Program Would Expand MH Crisis Services for Youth.”
(Image: Getty Images/iStock/Chalongrat Chuvaree)
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