Mental Health Treatment (Inpatient) for Children and Teens

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KEY POINTS

• Inpatient treatment is 24-hour care by mental health professionals and healthcare providers in a psychiatric hospital or residential treatment program.
• How long your child will be in treatment depends on the severity of your child's behaviors and symptoms and how they respond to treatment.
• It helps if you work with teachers, therapists, and other people who care for your child to share information and plan next steps.

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What is inpatient treatment?

Inpatient treatment is 24-hour care by mental health professionals and healthcare providers in a psychiatric hospital or residential treatment program.

• Hospital treatment usually offers intensive psychiatric treatment, nursing, and therapy. A hospital is always a secure (locked) facility. Hospitals generally have separate units for children (preschool to about age 12) and teens (12 to 18). Children and teen units are separate from mentally ill adults.
• Residential treatment can help children and teens who need ongoing treatment after psychiatric care in a hospital. Residential treatment programs provide intensive help for serious emotional, behavioral, or substance abuse problems. Your child will live at the center and be supervised and monitored by trained staff. Some, but not all, residential treatment programs are secure.

When is it used?

Your child may need to be in a hospital if he is:

• A danger to himself or others
• Addicted to drugs and needs medical care
• Not able to eat, sleep, or go to school
• Not able to do his normal activities because he is hearing or seeing things that are not there

Sometimes parents make this decision, or it may be ordered by a court.

How do I prepare for inpatient treatment?

Your healthcare provider or mental health professional will talk about your child’s choices for treatment and explain the program and any risks. You should understand what the treatment involves, how it will help your child, and how long it will take your child to recover.

If you need to get your child admitted to a hospital right away, you will need to rely on the advice of your healthcare provider. When there is more time to make a decision start by researching several facilities close to where you live. Call each program you are considering. Ask about waiting lists and admission requirements. Then visit each facility. Ask questions such as:

• What does the program include?
• Is this treatment program specifically for children and teens?
• What are the credentials and experience of the members of the treatment team?
• If English is not my family’s primary language, or if my family practices a certain religion how will the program address this?
• How will my child be able to keep up with schoolwork?
• How long will my child be in the hospital? How will you decide when treatment is complete?
• Does my child have other mental health or substance abuse problems? If so, will these also be treated?
• How often will my child see a psychiatrist and an individual therapist?
• What will treatment cost? Are the costs covered by my insurance or health plan?
• What happens if I can't afford the treatment my child needs?
• How will I be involved in my child’s treatment and decisions about treatment and discharge?
• When and how often can I visit my child?
• What can family members do to make my child's treatment successful?
• Once my child is discharged, what types of ongoing treatment will be needed, how often, and for how long?

What happens during treatment?

Inpatient treatment may include several kinds of therapy.

• Family therapy is often very helpful. Family therapy treats all members of the family rather than working with one person alone. It helps the whole family to make changes.
• Group therapy can help your child deal with work, relationships, and taking medicine. It takes place in a group of 6 to 10 people, under the guidance of a therapist.
• Supportive therapy gives encouragement ("you can do it"), positive feedback ("you are good enough"), and reassurance ("you can handle it").
• Cognitive behavior therapy (CBT) is a way to help your child identify and change views he has of himself, the world, and the future. CBT can make your child aware of unhealthy ways of thinking. It can also help him learn new ways to think and act.
• Your child will also see a psychiatrist daily in the hospital and at least twice a week in a residential program. Psychiatrists can prescribe medicines as well as provide therapy. Medicines may help children and teens who are depressed, anxious, or psychotic. Some medicines decrease the cravings for alcohol or drugs, and some make your child sick when he drinks or takes drugs. This may reduce the chances that your teen will abuse drugs or alcohol in the future.

How long your child will be in treatment depends on the severity of your child's behaviors and symptoms and how they respond to treatment. Your child may be in the hospital for only a few days or may need to stay longer. Residential treatment may last 6 months or longer.

What can I do to help my child?

• Support your child. Encourage children to talk about whatever they want to talk about even if it’s about anger at you or others in your family. Be a good listener. This helps children begin to realize that their feelings and thoughts really do matter, that you truly care about them, and that you never stopped caring. Avoid arguments. If your child shuts you out, don't walk away. Let children know that you are there for them whenever they need you. Remind children of this over and over again. They may need to hear it a lot because they feel unworthy of love and attention.
• Be involved in your child’s treatment. Talk to your child’s psychiatrist and therapist. Ask questions and find out ways you can help your child. Don’t hesitate to express any concerns that you have about how your child is doing or the treatment that your child is receiving. Contact your child’s school to talk about services your child will need.
• After your child completes inpatient treatment, you may want to enroll your child in a special program (such as day treatment) where he receives therapy as well as education. Stay in touch with teachers, therapists, and other people who care for your child to share information about symptoms your child may be having.
• Be consistent. Understand that you are not responsible for your child's problems, even if something such as a divorce may have triggered it. Be firm and consistent with rules and consequences. Your child needs to know that the rules still apply to them. It does not help to teach children that they can avoid consequences if they’re depressed or if they act out.
• Help your child learn to manage stress. Teach children and teens to practice deep breathing or other relaxation techniques when feeling stressed. Help your child find ways to relax, for example take up a hobby, listen to music, watch movies, or take walks.
• Take care of your child’s physical health. Make sure your child eats a healthy diet and gets enough sleep and exercise every day. Teach children and teens to avoid alcohol, caffeine, nicotine, and drugs.
• Check your child’s medicines. Tell all healthcare providers who treat your child about all medicines the child takes to make sure there is no conflict with medicines for mental health treatment. Make sure your child takes his or her medicines every day, even if feeling well. Stopping medicines when he or she feels well may start the problems again.
• Ask children or teens if they are feeling suicidal or have done anything to hurt themselves. Get emergency care if your child or teen has ideas of suicide or harming others or harming him- or herself.

Family patterns often need to change to help your child best. You may be asked to:

• Go to family therapy or take parenting classes.
• Learn all you can. Read, join support groups, and network with others who are dealing with similar mental health problems so that you do not feel alone.

For more information, contact:

• National Alliance on Mental Illness (NAMI)
  800-950-6264
  https://www.nami.org
• Mental Health America
  800-969-6642
  http://www.mentalhealthamerica.net/