When hospital harms more than helps: Iatrogenic processes in adolescent inpatient settings.

Abstract

More adolescents than ever are being hospitalised in mental health units. As with all forms of clinical intervention, psychiatric inpatient admission poses its own risks of harm resulting from treatment (iatrogenesis), of which there is minimal literature. In this article we explore the factors that contribute to iatrogenic processes in the adolescent inpatient environment. Of note, the socialization of unsafe behaviours in these environments can contribute to poorer treatment outcomes as well as the harmful effects of experiencing, or witnessing, coercive and traumatising clinical practices. Inpatient admissions also have a systemic impact on family and community ecosystems that can detrimentally influence young people while they are in hospital and even after returning to the community. Recommendations for minimizing and preventing iatrogenic harm for adolescents in inpatient environments are outlined, as well as the patient characteristics that might make young people more vulnerable to these deleterious processes.