Psychiatric hospital service utilization of children and adolescents in state custody

Scott C. Leon, Nina D. Uziel-Miller, John S. Lyons, Peter Tracy

Research output: Contribution to journalArticlepeer-review

47 Scopus citations


Objective: To examine factors related to psychiatric hospitalization decision and length of stay of wards of the Illinois Department of Child and Family Services. Method: A prospective design was implemented using the Childhood Severity of Psychiatric Illness (CSPI), a reliable, quantitative measure of psychiatric severity and its mediating factors. The CSPI was completed by hospital screeners upon conclusion of their crisis interviews. In addition to completing the CSPI, workers reported on demographic information, DSM-IV diagnoses, prescreening living arrangements, and length of hospital stay. Results: CSPI variables could effectively predict decision to admit versus deflect. The overall accuracy of this statistically significant prediction model was 77.9%, which was replicated on a new sample. Factors associated with decision to hospitalize are clinical in nature; ratings of suicidality, dangerousness, and impulsivity contributed the most to the model. Predicting length of stay was only moderately successful. Despite achieving significance, the model accounted for just 15.1% of length of stay variance using a multiple regression. Factors associated with length of stay were largely nonclinical in nature: living arrangement stability, region of the hospitalization, and age. Conclusions: These results can be used to assess how decisions regarding level and duration of care are currently being made as a point of departure for quality improvement efforts.

Original languageEnglish
Pages (from-to)305-310
Number of pages6
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Issue number3
StatePublished - 1999


  • Child welfare
  • Decision- making
  • Outcomes
  • Psychiatric hospitalization
  • Service use

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health


Dive into the research topics of 'Psychiatric hospital service utilization of children and adolescents in state custody'. Together they form a unique fingerprint.

Cite this