Soutullo Olivia, Coleman Lael, Hamburger Samantha, Cooke Frances, Zlotnik Deborah, Tyson Colby, Punnoose Priya, Long Melissa
Children's National Hospital, Washington, DC, USA.
George Washington University, Washington, DC, USA.
J Clin Psychol Med Settings. 2025 May 9. doi: 10.1007/s10880-025-10080-6.
Pediatric patients who have been discharged from psychiatric hospitalizations are at high risk of negative outcomes, especially if they do not connect to outpatient mental health services. This paper describes the development and implementation of the Transitional Care Coordination Program (TCCP), a novel adaptation of the Child Psychiatry Access Program (CPAP) model, to provide mental health consultation and care coordination services after psychiatric hospitalization. The program offered discharging patients' pediatric primary care providers telephonic child psychiatry consultations and three months of care coordination for patient families over multiple timepoints. Between March 2020 and November 2021, 163 unique patients were enrolled in the TCCP from 170 admissions. Patient families from 89 admissions (52% of total) were reached and participated in the TCCP, with 22 of those (25%) requesting new behavioral health provider resources and 39 (44%) requesting other behavioral health supports. The TCCP reached out to 110 (65% of total) primary care providers, none of whom requested a psychiatric consultation. Findings support the initial feasibility of a novel adaptation of the CPAP model for preemptive support at psychiatric hospitalization discharge. This is the first program of its kind, showing promise as a way for existing CPAPs to leverage their infrastructure to help families connect to needed mental health care after discharge and potentially prevent readmissions or other adverse outcomes. More research is needed to understand its efficacy and applicability to other settings.
已从精神病院出院的儿科患者面临负面后果的高风险，特别是如果他们没有接入门诊心理健康服务。本文描述了过渡性护理协调项目（TCCP）的开发与实施，这是儿童精神病学接入项目（CPAP）模式的一种新颖改编，旨在提供精神病院住院后的心理健康咨询和护理协调服务。该项目为出院患者的儿科初级保健提供者提供电话儿童精神病学咨询，并在多个时间点为患者家庭提供为期三个月的护理协调服务。在2020年3月至2021年11月期间，共有170例入院患者中的163例独特患者纳入了TCCP。来自89例入院患者（占总数的52%）的患者家庭得以联系并参与了TCCP，其中22例（25%）请求提供新的行为健康提供者资源，39例（44%）请求提供其他行为健康支持。TCCP联系了110名（占总数的65%）初级保健提供者，他们均未请求进行精神病学咨询。研究结果支持了对CPAP模式进行新颖改编以在精神病院出院时提供先发制人支持的初步可行性。这是同类项目中的首个项目，有望成为现有CPAP利用其基础设施帮助家庭在出院后接入所需心理健康护理并潜在预防再次入院或其他不良后果的一种方式。需要更多研究来了解其疗效以及在其他环境中的适用性。
