21.3 Evaluation of an Inpatient Psychiatric Hospital Unit Psychology Consultation Model: Quality, Satisfaction, and Areas of Improvement

Abstract

Inpatient psychiatric hospitalization (IPH) rates for youth increased 104% between 2006 and 2011, costing billions of dollars annually. The complexity and acuity of patients on psychiatric inpatient units require a multidisciplinary model of care. But the role of psychology on IPH units varies due to many factors, including the aim and scope of the intervention model and allotted psychology time. The purpose of the current implementation study was to obtain an understanding of stakeholders’ perspectives of the importance of psychological services on the IPH unit. We hypothesized that: 1) the top 5 treatment priorities for psychology time would be highly distinct from other suggestions; 2) providers would be dissatisfied with the quantity of psychology time available; and 3) providers and caregivers would be satisfied with the caregiver group intervention. Inpatient unit providers (n = 43) stated their preferences for the optimal use of psychology time, as part of an 8-hour/week consultation model. They also responded to their satisfaction with elements of the consultation model including a 1-hour/week caregiver group. Caregivers (n = 49) provided feedback on their satisfaction levels with the group. Seventy-three percent of staff (n = 35) reported insufficient psychology time offered in the current 8-hour consult model. Behavior plans, caregiver groups, and psychoeducation on exposure techniques were identified as the top 3 priorities utilizing psychology time. Providers were split around their satisfaction with the amount of psychology time with the treatment team (39.6% satisfied; 37.5% dissatisfied; remainder not specified). Seventy-three percent of staff expressed satisfaction with the caregiver group (n = 43; p < 0.05), while 88% (n = 43; p < 0.05) of caregivers expressed satisfaction with the content covered. IPH unit providers generally agreed on more psychology time and ways to use an 8-hour/week psychology consultation model to meet milieu and patient needs but were split on their satisfaction of the quantity of psychology time with the treatment team. Caregivers were highly satisfied with the use of psychology to assist parents with discharge planning and skills training.