All About Psychiatric Hospitalization in Adolescents

Psychiatric hospitalization in adolescents should be an exceptional resource and not the rule, depending on the seriousness of the issue.

Written and verified by the psychologist Maria Fátima Seppi Vinuales.

Last update: 29 August, 2023

Psychiatric hospitalization in adolescents is a vitally important issue that deserves special attention. During adolescence, young people experience a series of physical, emotional, and social changes that can lead them to face significant challenges with regard to their mental health.

According to the World Health Organization (WHO), 1 in 7 young people aged 10 to 19 years has a mental disorder. It adds another alarming fact to this alarming figure: Suicide is the fourth leading cause of death among young people aged 15 to 29.

However, the mental health of adolescents isn’t always given the importance it deserves. In many cases, psychiatric hospitalization is necessary, but there are still many taboos and prejudices. This prevents the implementation of measures to accompany and protect young people. Let’s learn a little more about the subject.

Mental health in adolescents

The main causes of illness and disability among adolescents are linked to depression, anxiety, and behavioral disorders. In most cases, they start as a silent, disguised malaise.

As time goes by and the adolescent doesn’t get adequate attention, some signs that “something’s up” start to become visible. Unfortunately, these signs sometimes arrive late, as there’s still a stigma attached to mental health.

In addition to this, we live in a fast-paced context, where it’s often difficult to understand and detect what’s going on. In other cases, we find ourselves in situations of vulnerability and denial.

Sometimes, the family “lives” for months with the suffering adolescent. In the best of cases, they try to approach them, talk to them, motivate them, and even initiate therapy. But it’s not always enough. Discouragement “eats” them from the inside and that’s when psychiatric hospitalization – after several unsuccessful attempts – ceases to be the last option and becomes a priority, almost an emergency.

Psychiatric hospitalization in adolescents: What’s it all about?

First of all, with regard to psychiatric hospitalization, the human rights of those affected must always be taken into account. In this regard, many countries have laws or regulations related to Mental Health. Regardless of their situation, the person still has rights and deserves to be respected.

It’s also important to consider the context. In other words, when faced with complex situations, such as problematic substance use or suicide risk, the family isn’t usually prepared to deal with or contain the situation. This is particularly true in cases related to self-harm, depression, or eating disorders.

In most cases, psychiatric hospitalization is usually decided when previous instances have already been exhausted. For example, in eating disorders (ED), such as anorexia, the family tries to convince the adolescent to eat.

However, as the months go by, the weight loss becomes so significant that it becomes dangerous and unmanageable. At this point, the intervention of a team of professionals is decisive.

Psychiatric hospitalization of adolescents should have the following characteristics:

• They should be brief. They shouldn’t be extended beyond what’s necessary. Once the adolescent’s condition improves, it can even be combined with outpatient treatment.
• The case should be considered on an individual basis. Psychiatric hospitalization shouldn’t be applied as a general rule but what’s best for the patient should be considered. In this regard, the clinical history of the person should be analyzed with criteria and reconstructed.
• Hospitalization may imply follow-up and interdisciplinary work to increase the probabilities of effectiveness, as explained in a study published in the Chilean Journal of Neuro-Psychiatry.
• The consent of the patient should be given. Involuntary hospitalizations are discouraged. Of course, this criterion depends on whether or not there’s a perceived danger and risk for the person themself or for third parties.
• The patient should be allowed and encouraged to have the support and participation of their family, as well as the relationship with the community.
• It shouldn’t be the first measure or the final measure. Different types of treatment and approaches should be provided. Hospitalization often implements a restrictive regimen that, sustained over time, can be detrimental.

Some recommendations regarding psychiatric hospitalization

Here are some thoughts on psychiatric hospitalization in adolescents and possible reactions to the different phases before, during, and after hospitalization.

Talking to the adolescent

It’s important to be able to explain that hospitalization doesn’t mean “giving up”, “losing confidence in their recovery”, or abandonment. It means a commitment to well-being and recognizing that the family and the adolescent need help.

It’s also important to address emotions, help the adolescent not to feel guilty, and support them in the search for the meaning of recovery–a “why” that motivates them to get better. In other words, promote resilience.

Paying attention to the family climate

It’s logical that attention has been focused on the person in need of help. However, the rest of the family members shouldn’t be neglected. It’s always good to stop and ask how each one feels and what they need in order to get through this moment.

In turn, if there are siblings of different ages, it’s important for them to be able to talk about their fears and questions, as each one may be concerned or affected by something different.

Preparing for discharge

Of course, once the hospitalization is over, it’s important to accompany the adolescent and the family to this “new” old reality. This requires working on emotions, fears, and insecurities.

Generate a space for dialogue where everyone can express themselves and get rid of any doubts about what’s going to happen and how everything’s going to continue. It’s also about thinking in terms of stages, as hospitalization isn’t the end of everything. Treatment doesn’t end upon discharge. On the contrary, a new phase is entered.

Protecting rights is protecting health

Regarding psychiatric hospitalization, it’s important to understand that they should follow certain principles based on Human Rights and recommendations from health organizations.

These principles seek to prevent placements from becoming total isolation and a closed place. Rather, it’s about protecting people’s rights and only resorting to that which is necessary to ensure a person’s well-being.

To conclude, it’s possible to think of an analogy. Remember during the pandemic when your circulation was restricted and you were unable to leave your house for weeks at a time? Think about how that affected your mood. If you were already experiencing some difficulty, isolation may have even accentuated it.

Now, when the confinement is prolonged, it’s very easy to start to feel that way, to lose your senses, and to feel cut off from everything. For this reason, psychiatric hospitalization in adolescents can be a kick-start to stabilize certain aspects, establish order, and organize a routine. In short, to start treatment.