The factors influencing decision making on children's psychiatric hospitalization: A retrospective chart review

Indications and criteria for psychiatric hospitalization (PH) continue to be questioned and assessed. We investigated the major clinical criteria affecting child psychiatrists' decision to recommend hospitalization. Records of 80 children (aged 7-13 years) treated at the Geha Mental Health Center's (GMHC's) outpatient clinic were reviewed. The patients' files were divided into three groups: admitted to PH (n = 20), candidates for PH who, ultimately, were not hospitalized (n = 20) and 40 patients for whom PH was not a consideration. Three groups of criteria were chosen to evaluate the decision for PH (type and severity of the psychiatric disorders, family's level of distress and parental capacity to contain the child). These criteria were rated quantitatively by using CGI-S. Highly significant inverse association was found between the level of parental capacity to contain the child and the decision to hospitalize in a psychiatric pediatric institution. The correlations between severity of the psychiatric disorders and family's level of distress was also found significant, but to a lesser extent. Parental capacity to contain the child, with its various components, is a major factor in the decision making process, when referring children to PH. This is the first study, demonstrating a strong association between parental-capacity components and the rate of hospitalization.