Teenagers in acute mental health crisis who receive intensive community care services as an alternative to hospitalization do as well or even slightly better on several psychological, social, and clinical measures outcomes, according to a report in the Journal of Child and Adolescent Psychiatry.Why It’s Relevant
While inpatient care can stabilize people in acute crisis, extended inpatient stays isolate teens from their families, friends, and schools and increase the risk of institutionalization. “To address these challenges, intensive community care services (ICCS), such as home treatment, assertive outreach, and multisystemic therapy services, are increasingly implemented as alternatives to hospitalization,” the researchers wrote. However, they added that the effectiveness of ICCS relative to alternatives like traditional inpatient or outpatient care remains unclear.
By the Numbers
- The researchers compiled data from 48 studies comparing ICCS with usual care (including inpatient care and residential services). The studies included 6,917 adolescents between 12 and 18 from the United States and nine other high-income countries.
- ICCS were associated with a small but statistically significant improvement in overall psychosocial functioning relative to usual care (Hedges’ g of 0.15), as well as slight reductions in inpatient admission days, emotional and behavioral problems, and externalizing symptoms.
- ICCS were comparable with usual care when it came to internalizing symptoms, family cohesion, and cost.
- When compared solely against inpatient care, ICCS remained superior at improving psychosocial functioning (Hedges’ g of 0.25); all other outcomes were comparable.
The Other Side
The researchers acknowledged that many of the studies had methodological problems, particularly related to outcome measurement and lack of pre-specified protocols, as well as relatively short follow-up times. The data were also limited to high-income countries and had inconsistent sociodemographic reporting.
Takeaway Message
“Overall, the findings support ICCS expansion as a viable alternative to inpatient care for many adolescents,” the researchers wrote, adding that future work should prioritize multisite clinical trials that compare different ICCS models, assess cost-effectiveness more robustly, and study long-term outcomes.
Related Information
Source
Shabeer Syed et. al. Systematic review and meta-analysis: effectiveness of intensive community care services and psychosocial interventions for adolescents with severe mental health problems. Journal of Child and Adolescent Psychiatry. Published January 22, 2026. doi: doi.org/10.1016/j.jaac.2026.01.006
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