[Changes in the Psychiatric Prevalence and Stress Level Among Clients of Residential Youth Care Centers in Switzerland? An Evaluation of the Routine Diagnostics of a Swiss Youth Home].

Abstract

Changes in the Psychiatric Prevalence and Stress Level Among Clients of Residential Youth Care Centers in Switzerland? An Evaluation of the Routine Diagnostics of a Swiss Youth Home Abstract: Objective: The sharp rise in inpatient admissions of adolescents poses a challenge for both psychiatric care and policymakers. Residential facilities within the youth welfare system are becoming increasingly burdened at the care interfaces. However, we cannot determine the extent of the problem because of the broad lack of studies on the prevalence of mental disorders and their severity in residential youth homes - especially in light of the lack of long-term studies of their presumed increase. An analysis of data from the Burghof Pestalozzi-Jugendstätte - an institution of the youth welfare system in German-speaking Switzerland providing comprehensive psychiatric and psychological care - should result in better information. Method: We analyzed the frequency of ICD-10 diagnosis categories, the global psychosocial functioning level according to MAS Axis VI, a so-called dissocialization index, and other variables statistically using systematically documented retrospective data on all 448 admissions between 2008 and 2022. Results: The prevalence of mental disorders was very high at 80-90 %. It was both cumulatively comorbid, with a shift from mainly externalizing to increasingly internalizing symptoms, a deterioration in the level of psychosocial functioning and performance on socialization pathways, and a decrease in age at admission. Conclusions: Increasing the pressure to address the psychiatric care needs of young people is becoming more and more noticeable in residential youth care facilities, which are confronted with a growing responsibility for psychiatric care tasks. Because the demands on social and vocational integration remain unchanged, these facilities must be able to respond by increasing both their effectiveness and their capacity.