The rapid stabilization pathway: impact of a brief inpatient intervention on the length of stay and readmissions among psychiatrically hospitalized adolescents

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Family intervention and Cognitive Behavior Therapy contribute to reductions in suicidality in adolescents.

“consistent with findings of other studies demonstrating that family intervention and Cognitive Behavior Therapy (CBT) contribute to reductions in suicidality in adolescents (e.g.Asarnow, Hughes, Babeva, & Sugar, 2017;Esposito-Smythers, Spirito, Hahler, Hunt, & Monti, 2011).”

• cites Asarnow, Hughes, Babeva, & Sugar, 2017 sourceSupported
• cites Esposito-Smythers, Spirito, Hahler, Hunt, & Monti, 2011 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The average age of the 119 RSP-eligible patients was 14.7 years (SD 1.6); 68.9% were female; 69.7% were White, non-Latinx, 13.4% Black, non-Latinx, and 9.2% Latinx.

“The average age of these patients was 14.7 years (SD 1.6).Eighty-two (68.9%) were female.Regarding race/ethnicity, 83 (69.7%) patients were White, non-Latinx, 16 (13.4%)were Black, non-Latinx, and 11 (9.2%) were Latinx.”

May combine two claims.

Preliminary data analyses since the eligibility expansion show an average LOS of 3.8 days, suggesting that including patients with prior inpatient admissions and from pediatric floors did not increase LOS for RSP patients.

“Preliminary data analyses since the eligibility expansion shows an average LOS of 3.8 days suggesting that including patients with prior inpatient admissions and from our pediatric floors did not increase LOS for RSP patients.”

May combine two claims.

There was no significant difference in number of readmissions or CPEP visits between RSP and TAU patients at postdischarge time points.

“Further, there was no significant difference in readmission to the inpatient unit or to the psychiatric emergency room among RSP and TAU patients at 30, 60, and 90 days postdischarge.”

• Also stated in: § Results · plain

  “There was no significant difference in number of readmissions or CPEP visits between RSP and TAU patients though RSP patients did have fewer readmissions and CPEP visits at all time points.”

May combine two claims.

There was not a statistically significant relationship between receiving the RSP intervention and age, gender, or race/ethnicity.

“There was not a statistically significant relationship between receiving the RSP intervention and age (t [117] = 1.06, p = .29),gender (female vs. other, X 2 [1, 119] = 0.07, p = .79),or race/ethnicity (White, non-Latinx vs. other, X 2 [1, 119] = 0.18, p = .67).”

Probably not a substantial claim: may not pass S3 (load-bearing).

Approximately one-fourth of eligible patients (25.2%) were treated with RSP due to therapist availability.

“Approximately one-fourth of eligible patients (25.2%) were treated with RSP (due to therapist availability).”

May combine two claims.

RSP patients had fewer readmissions and CPEP visits at all time points, though the difference was not statistically significant.

“There was no significant difference in number of readmissions or CPEP visits between RSP and TAU patients though RSP patients did have fewer readmissions and CPEP visits at all time points.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Demand for psychiatric emergency services and inpatient beds is increasing while available beds decrease or remain static, leading to delays in treatment and symptom exacerbation for some adolescents awaiting care.

“the demand for psychiatric emergency services and inpatient beds is increasing, while the number of beds available decreases or remains static (National Association of State Mental Health Program Directors, 2017).”

• cites National Association of State Mental Health Program Directors, 2017Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing).

Safety planning, including collaborative development of a written safety plan to identify warning signs and coping skills, is a generally accepted standard of care in acute psychiatry.

“Safety planning, inlcuding the collaborative development of a written safety plan to identify warning signs and coping skills is a generally accepted standard of care in acute psychiatry (Stanley & Brown, 2012).”

• cites Stanley & Brown, 2012 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

COPES demonstrated good feasibility and acceptability, as well as a decrease in readmission and re-presentation to psychiatric emergency departments following an inpatient stay.

“A similar CBT-based intervention, COPES (Wolff et al., 2018), also demonstrated good feasibility and acceptability, as well as a decrease in readmission and re-presentation to psychiatric emergency departments following an inpatient stay.”

• cites Wolff et al., 2018 sourceNot checked — no full text of the source

Classified as probably not a substantial claim.

The Empowerment Plan integrates ACT tenets of value-driven living, expansion behavioral repertoires, and present-moment awareness into traditional safety planning.

“The Empowerment Plan (Weinstein, Kroska, & Walser, 2001) integrates ACT tenets of value-driven living, expansion behavioral repertoires, and present-moment awareness into traditional safety planning.”

• cites Weinstein, Kroska, & Walser, 2001Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

ACT is an empirically supported treatment approach rooted in Contextual & Behavioral Science, with broad applications.

“Acceptance & Commitment Therapy (ACT; Hayes, 2016) is an empirically supported treatment approach rooted in Contextual & Behavioral Science, which has broad applications.”

• cites Hayes, 2016 sourceNot checked — no full text of the source

May combine two claims.

A family-based cognitive behavioral treatment administered in a short-term acute psychiatric unit for adolescents was feasible and acceptable, with high levels of patient and parent satisfaction.

“Their findings support the feasibility and acceptability of the intervention, with high levels of patient and parent satisfaction.”

• cites McBee-Strayer et al. (2019) sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S4 (based).

Taken together, these studies support the feasibility of brief intensive interventions in hospitalized adolescents.

“Taken together, these studies support the feasibility of brief intensive interventions in hospitalized adolescents.”

May combine two claims.

MI-Safe-Cope intervention was feasible to administer in an acute inpatient milieu and was found to be acceptable to adolescents and their parents.

“Results showed that the intervention was feasible to administer in an acute inpatient milieu and was found to be acceptable to adolescents and their parents.”

• cites Cycz, King, & Biermann, 2018Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing).

The number of adolescents hospitalized with suicidal ideation and/or attempts more than doubled between 2008 and 2017.

“The number of adolescents hospitalized with suicidal ideation and/or attempts has more than doubled between 2008 and 2017 (Plemmons et al., 2018), creating a parallel crisis in access to necessary mental health care.”

• cites Plemmons et al., 2018 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

There is emerging data on the feasibility and efficacy of ACT-based interventions with psychiatrically hospitalized adults in reducing suicidality by infusing ACT principles into safety planning.

“though there is emerging data on the feasibility and efficacy of ACT-based interventions with psychiatrically hospitalized adults (e.g.Barnes et al., 2021) in reducing suicidality by infusing ACT principles into safety planning.”

• cites Barnes et al., 2021 sourceNot checked — no full text of the source

May combine two claims.

The criteria for the RSP pilot reflected only 21% of admissions to the inpatient unit, excluding patients with more concerning prognostic indicators (e.g., CPS involvement, multiple psychiatric admissions), which limits the generalizability of the findings to the broader psychiatric inpatient population.

“Finally, the criteria for the RSP pilot reflected only 21% of admissions to the inpatient unit, excluding patients with more concerning prognostic indicators (e.g.CPS involvement, multiple psychiatric admissions).This limits the generalizability of the findings to the broader psychiatric inpatient population.”

May combine two claims.

Safely discharging patients quickly allows acute units to safely treat and discharge more patients and therefore increase access to psychiatric beds.

“Safely discharging patients quickly allows acute units to safely treat and discharge more patients and therefore increase access to psychiatric beds.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The ACT for Life protocol, developed for veterans receiving inpatient psychiatric care for suicidality, was found to be highly acceptable and feasible in a pilot study.

“Relatedly, the ACT for Life protocol, developed for veterans receiving inpatient psychiatric care for suicidality, was found to be highly acceptable and feasible in a pilot study (Barnes et al., 2021).”

• cites Barnes et al., 2021 sourceNot checked — no full text of the source

May combine two claims.

The RSP intervention significantly reduced adolescents' inpatient length of stay without significantly increasing the number of postdischarge hospital readmissions or CPEP visits.

“Results of this pilot study indicate that the RSP intervention significantly reduced adolescents' inpatient length of stay without significantly increasing the number of postdischarge hospital readmissions or CPEP visits.”

Probably not a substantial claim: may not pass S3 (load-bearing).

This increase in access could lead to fewer patients boarding in emergency departments.

“This increase in access could lead to fewer patients boarding in emergency departments, a common practice that is often detrimental to patients and families.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

It is challenging to assess which components of the RSP intervention are most efficacious.

“Relatedly, while the creativity and flexibility of the RSP is a strength, it is challenging to assess which components of the intervention are most efficacious.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Patient satisfaction outcome measures postdischarge were not obtained.

“Patient satisfaction outcome measures postdischarge were not obtained.”

May combine two claims.

For a 27-bed unit such as CAPIU, 42 patients could be treated with RSP in the same number of bed-days as 27 non-RSP patients; an RSP 'bed' is equivalent to more than 1.5 traditional psychiatric beds.

“Specifically, given the reduced length of stay for RSP patients compared to traditional care, for a 27-bed unit such as our CAPIU, 42 patients could be treated with RSP in the same number of bed-days as 27 non-RSP patients.In other words, an RSP 'bed' is the equivalent to more than 1.5 traditional psychiatric beds.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Due to therapist availability, therapy sessions were only provided on weekdays, creating a gap in therapeutic support over weekends and increasing total length of stay.

“Also, due to therapist availability, therapy sessions were only provided on weekdays creating a gap in therapeutic support over the weekends and increasing total length of stay.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The authors have declared that they have no competing or potential conflicts of interest.

“The authors have declared that they have no competing or potential conflicts of interest.”

May combine two claims.

Only one treatment team and therapist provided the RSP intervention, leading to uncertainty about the generalizability of the intervention.

“In addition, only one treatment team and therapist provided the RSP intervention leading to uncertainty about the generalizability of the intervention.”

• Also stated in: § Discussion · plain

  “During the pilot, the RSP intervention was provided by only one clinician who had multiple other responsibilities.”

Probably not a substantial claim: may not pass S3 (load-bearing).

University of Rochester Office for Human Subject Protection (RSRB) determined on 11/22/21 that the study meets federal and University criteria for exemption.

“University of Rochester Office for Human Subject Protection (RSRB) determined on 11/22/21 that the study (ID 00006813) meets federal and University criteria for exemption.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

ACT has been applied to adolescents by Hayes and Ciarrochi (2015), who developed the DNA-V model to better meet the developmental needs of young people.

“ACT has been applied to adolescents by Hayes and Ciarrochi (2015), who developed the DNA-V model to better meet the developmental needs of young people.”

• cites Hayes and Ciarrochi (2015)Not checked — no full text of the source