Emergency psychiatry Mental and Behavioural Disorders Mental disorder, not otherwise specified
Conditions
Interventions
54 adolescents will receive usual in-patient care and 54 will be discharged early with intensive community support provided by the new Supported Discharge Service.
Supported Discharge Service (SDS)
Sponsors
King's College London (UK)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Young people aged 12-18 2. Patients of South London and Maudsley NHS Foundation Trust 3. Admitted for in-patient care
Exclusion criteria
Exclusion criteria: 1. Emergency admissions who at the first point of assessment by clinicians in the inpatient teams are judged not to be suffering from a psychiatric illness warranting inpatient care (and therefore ready for immediate discharge) 2. Those discharged within 72 hours of admission 3. Young people admitted from Tier 4 National and Specialist services
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Current primary outcome measures as of January 2013 (updated 16/08/2017): 1. Duration (in days) of the psychiatric in-patient treatment (Occupied Bed Days) in the 6 month period following randomisation 2. The CGAS (Children?s Global Assessment Scale). This is a paediatric measure of general functioning (Shaffer, Gould, Brasic, et al, 1983) 3. The SDQ (Strengths and difficulties questionnaire, children?s and parents? versions). This is a broad measure of psychopathology in children and adolescents (Goodman, 1999) Previous primary outcome measures: 1. Duration (in days) of the psychiatric in-patient treatment (Occupied Bed Days) in the 6 month period following randomisation 2. The CGAS (Children?s Global Assessment Scale). This is a paediatric measure of general functioning (Shaffer, Gould, Brasic, et al, 1983) | — |
Secondary
| Measure | Time frame |
|---|---|
| Current secondary outcome measures as of January 2013 (updated 16/08/2017): 1. Self Harm Questionnaire 2. The CGI-I (Clinical Global Impression, Improvement). This is a brief clinician rated scale assessing clinical improvement. This scale has now been validated for a range of conditions in both psychotherapy and pharmacotherapy trials (Haro, Kamath, Ochoa, et al, 2003; Huber, Lambert, Naber, et al, 2008; Perez, Barrachina, Soler, et al, 2007; Zaider, Heimberg, Fresco, et al, 2003) 3. Service satisfaction survey 4. Proportion of the young people who disengage from treatment 5. The HoNOSCA (Health of the Nation Outcome Scales for Children and Adolescents) is a clinician rated tool that assesses symptom severity and function across a range of psychosocial domains (Gowers, Harrington, Whitton, et al, 1999) 6. Qualitative experience of the young people studied using Phenomenological Interpretative Analysis (Smith, 1996; Smith & Osborn, 2003) 7. Cost: in order to estimate the overall cost of each intervention, information on the use of all hospital and community services will be collected prospectively for each patient over the study period. A number of sources will be used including the electronic Patient Journey System, family interview at 6 months follow up and local authority social services departments? records. 8. Clinical diagnosis: K-SADS-PL (Schedule for Affective Disorders and Schizophrenia for School-Age Children--Present and Lifetime Version) 9. Number of days attending education employment or training 10. Columbia Impairment Scale (Bird et al 1993) Previous secondary outcome measures: 1. The SDQ (Strengths and difficulties questionnaire, children?s and parents? versions). This is a broad measure of psychopathology in children and adolescents (Goodman, 1999) 2. The CGI-I (Clinical Global Impression, Improvement). This is a brief clinician rated scale assessing clinical improvement. This scale has now been validated for a range of conditions in both psychot | — |
Countries
United Kingdom
Outcome results
None listed