Innovation in Acute Adolescent Mental Healthcare: Evaluating a Responsive and Sustainable Mental Healthcare Model

Vollständiger Abstract

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Background and objectives: Despite the substantial global burden of mental illnesses, there remains limited evidence evaluating the effectiveness of inpatient Models of Care (MOCs) for adolescents. This paper compares the effectiveness of an innovative MOC, the Brief Intervention MOC (BIMOC), with the Traditional MOC in an acute adolescent inpatient unit. Comparisons were based on clinical outcome measures and several Key Performance Indicators (KPIs) (length of stay, 28-day readmission rate, 7-day follow-up rate, seclusion rate, and self-harm incidents), which were tracked over the subsequent years to evaluate BIMOC’s effectiveness and sustainability. Materials and Methods: A retrospective, single-center, quasi-experimental non-randomized before-and-after study using historical controls was conducted. Clinical outcomes were assessed using the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) and the Children’s Global Assessment Scale (CGAS). Service-level KPIs were compared across models. Descriptive statistics, paired-samples t-tests, Cohen’s d, and z-tests were used to evaluate changes within models and compare outcomes between models. Results: Within the BIMOC, both acute and crisis subgroups showed substantial improvements, with mean CGAS scores increasing from 27.67 to 49.76 and mean HoNOSCA scores decreasing from 19.30 to 9.96 (p < 0.001). Overall, both models demonstrated significant improvements from admission to discharge. Effect size analysis indicated greater functional gains under the BIMOC compared with the TMOC (d = 1.89 vs. 1.22; z = −3.694, p = 0.0002), while no statistically significant difference in symptom improvement was detected between the two MOCs (z = −0.769, p = 0.4418). KPI data analysis identified favorable patterns in several service-level indicators during the BIMOC period compared to the TMOC period, including reduced length of stay (21.0 vs. 13.6 days), reduced 28-day readmission rates (11.9–17.0% vs. 8.1%), and increased 7-day follow-up completion (approximately 60% vs. 76.8%). Conclusions: The study suggests that a structured and integrated inpatient MOC (BIMOC) incorporating multidisciplinary collaboration, family involvement, and coordinated discharge and follow-up processes may support positive clinical and service-level outcomes in adolescent mental health inpatient settings. However, given the observational before-and-after design, the findings should be interpreted cautiously and do not establish causality.