PolicyLab

Dr. Stephanie Doupnik is working to better understand the relationship between hospitalization and mental health conditions in children. Over the past few years, she has built a research portfolio that provides a comprehensive picture of the many ways in which mental health conditions affect health care delivery, utilization, costs and outcomes for children, including by putting children at higher risk of the following:

• Medical Complications During Hospitalization: One study examined the influence of mental health conditions on hospital outcomes among children hospitalized for pneumonia and found that mood or anxiety disorders were associated with more medical complications and longer hospital stays.
• Readmissions: Children with mental health conditions were more likely to be readmitted to the hospital within 30 days of discharge after a medical hospitalization or surgical procedure compared to children without mental health conditions.
• Health Care Utilization and Costs: Another study showed that hospitalized children with comorbid mental health conditions had much longer hospital stays, which resulted in higher costs for the hospitals and health systems.
• Clinical Team and Family Communication: One study found that hospital staff and families may not be on the same page regarding mental health concerns and diagnoses in children. This may lead to missed opportunities to identify and provide treatments for children with mental illness.

Hospitals are testing innovative models for ensuring that children with mental health conditions and their families receive the evidence-based treatments and psychosocial support. Efforts include changes to physician training, integrating medical and psychosocial care, and programs designed to support parents. Ensuring the long-term success of care models that integrate behavioral health care into acute hospital care will require systems to monitor whether behavioral health services improve patient outcomes, for example by reducing the length of their hospital stay or the need for subsequent repeat hospitalizations, or by improving their functioning after they leave the hospital. Future work to investigate cost-effective payment models will also enhance the uptake of behavioral health integration within inpatient settings.