Factors related to psychiatric hospital readmission among children and adolescents in state custody

Objective: This study examined factors related to psychiatric hospital readmission among children and adolescents who were wards of the Illinois Department of Children and Family Services. Methods: The authors analyzed service reports and clinical ratings on the Childhood Severity of Psychiatric Illness (CSPI) for 500 randomly selected children and adolescents who underwent psychiatric hospitalization. Children who were readmitted to the hospital within three months of discharge from the index hospitalization were compared with those who were not readmitted in terms of preadmission factors, clinical characteristics at the index hospitalization, services in the hospital, and posthospital services. Results: The children who were readmitted were rated as more learning disabled or developmentally delayed and had received fewer posthospital service hours than the children who were not readmitted. The highest rates of readmission were found among children who lived in congregate care settings before the index hospitalization and those who lived in a rural region. Conclusions: The findings of this study highlight the significance of enabling factors, notably living arrangement, geographic region, and posthospital services, for children and adolescents in the child welfare system. Prevention of readmission among these children must focus on community-based services.