Extrait

Background and study aims Approximately 2000 adolescents are admitted for in-patient psychiatric care every year. These admissions often lead to serious distress. Suicide is the second leading cause of death in adolescents and the period after discharge from in-patient care is associated with the highest risk of suicide. Little is known about the best way to treat adolescents who need in-patient care. The main objective of this study is to evaluate two models of care for young people aged 12 to 18 requiring hospitalisation as a result of severe mental illness. The first model (treatment as usual) comprises admissions to adolescent units. The second (experimental) model will consist of initial inpatient care followed by early discharge to a newly established Supported Discharge Service, providing a combination of home treatment, day care or intensive case management according to need. For both care models the end point will be a return to routine outpatient care. Who can participate? Adolescents from the age of 12 to the age of 18 who are looked after by the South London and Maudsely NHS Foundation Trust and who need in-patient care will be eligible to participate. What does the study involve? 108 adolescents who are the patients of South London and Maudsley NHS Foundation Trust will be randomised. 54 adolescents will receive usual in-patient care and 54 will be discharged early with intensive community support provided by the new Supported Discharge Service. What are the possible benefits and risks of participating? Participants will be given a very comprehensive assessment which may be helpful for adolescents’ initial psychiatric assessment and treatment. Subjects participating in the assessment and follow-up phases of the study may potentially benefit by having a full research-standard psychiatric evaluation. The anticipated additional risks to subjects as a result of their participation in this study are minimal. The interviews carried out in this study may potentially cause psychological distress in subjects and their parents. Research clinicians, trained and supervised by the psychiatrists or psychologists participating in the study will conduct the interviews. Where is the study run from? The main centre taking part in this study is South London and Maudsley NHS Foundation Trust. In South London and Maudsley NHS Foundation Trust (SLaM) adolescent inpatient services are provided by three units: Snowsfields Adolescent Unit (SAU), Kent and Medway Adolescent Unit (KAMAU) and the Bethlem Adolescent Unit (BAU). In addition 12 and 13 year old patients may be treated at Acorn Lodge Children’s Unit. When all SLaM adolescent beds are occupied new admissions have to be placed in private adolescent units. When is study starting and how long is it expected to run for? The anticipated start of the study is September 2012 and the approximate duration of the study is 33 months. Who is funding the study? The Maudsley Charity and the Guys' and St Thomas' Charity Who is the main contact? Dr Dennis Ougrin [email protected]

Critère d'inclusion

• Emergency Psychiatry

Liens

• isrctn
• ictrp