Zuccala Matteo, Webb Shannon, Yong Choong-Siew
Brolga Adolescent Inpatient Unit, Hornsby Ku-ring-gai Hospital, Northern Sydney Local Health District, Australia.
School of Psychology, Faculty of Science, University of Sydney, Sydney, New South Wales, Australia.
Clin Child Psychol Psychiatry. 2025 Jul;30(3):670-682. doi: 10.1177/13591045251332134. Epub 2025 Apr 9.
More adolescents than ever are being hospitalised in mental health units. As with all forms of clinical intervention, psychiatric inpatient admission poses its own risks of harm resulting from treatment (iatrogenesis), of which there is minimal literature. In this article we explore the factors that contribute to iatrogenic processes in the adolescent inpatient environment. Of note, the socialization of unsafe behaviours in these environments can contribute to poorer treatment outcomes as well as the harmful effects of experiencing, or witnessing, coercive and traumatising clinical practices. Inpatient admissions also have a systemic impact on family and community ecosystems that can detrimentally influence young people while they are in hospital and even after returning to the community. Recommendations for minimizing and preventing iatrogenic harm for adolescents in inpatient environments are outlined, as well as the patient characteristics that might make young people more vulnerable to these deleterious processes.
如今，因心理健康问题而住院的青少年比以往任何时候都多。与所有形式的临床干预一样，精神科住院治疗也存在因治疗导致伤害（医源性伤害）的风险，而关于这方面的文献极少。在本文中，我们探讨了导致青少年住院环境中医源性过程的因素。值得注意的是，这些环境中不安全行为的社会化可能导致治疗效果更差，以及经历或目睹强制性和创伤性临床实践所产生的有害影响。住院治疗对家庭和社区生态系统也有系统性影响，这可能在青少年住院期间甚至出院回到社区后对他们产生不利影响。本文概述了在住院环境中尽量减少和预防青少年医源性伤害的建议，以及可能使年轻人更容易受到这些有害过程影响的患者特征。
