A mixed-methods investigation of parental burden and adolescent service use following discharge from psychiatric hospitalization

项目总结/文摘

Project Summary/Abstract Adolescents (age 12-17) are disproportionally impacted by mental health challenges. Suicide is a leading cause of death among this age group, with rates of psychiatric inpatient service use consistently increasing since the mid-2000s. Youth psychiatric hospitalization can be traumatic for families and the period following hospitalization is associated with increased risk of repeat suicide attempts and rehospitalization. Increased risk during this time may be due, in part, to low rates of follow-up service use. One factor that plays a substantial role in youth service use is parental burden (i.e., difficulties perceived to be caused or exacerbated by a child's psychiatric symptoms). However, research has not yet explored how parental burden is related to follow-up service use in the post- hospitalization period, or how disparities may influence this relation. Familial socioeconomic status (SES) may be particularly important to consider in this context. There exists a myriad of barriers faced by families of lower SES that impact access to and quality of mental health care. The present study seeks to address these gaps using a mixed methods design. The first aim of this study is to investigate the bidirectional associations between parental burden and youth service use over time following discharge from psychiatric hospitalization. The second aim is to examine how SES impacts the longitudinal relations between parental burden and youth service use. The third aim is to compare the lived experiences of 252 mothers with a recently psychiatrically hospitalized adolescent from high and low SES backgrounds, with a focus on perceptions of burden. Broadly, the fellow’s training goals associated with the proposed study and long-term career plans are to: develop comprehensive knowledge of relevant literatures, such as processes of post-traumatic growth and stress in families, health disparities, and culturally responsive care with underserved youth and families; develop proficiency in qualitative, mixed-methods, and advanced quantitative statistical design and analysis; and improve research dissemination skills. This will be accomplished through coursework, attendance at targeted workshops, hands-on research and clinical experience, directed readings, and regular mentorship meetings. With the support of a dedicated and experienced mentorship team, this research study and training plan will set the stage for the fellow’s long term research goal, which is to conduct culturally responsive, trauma-informed, and family-based treatment research.