At what cost? A qualitative study of youth and families' experiences of psychiatric hospitalization in Canada at the height of the COVID-19 pandemic.

Abstract

The COVID-19 pandemic coincided with increased diagnoses of psychiatric disorders and a rise in psychiatric hospitalizations in children and youth in Canada. The collateral effects of the pandemic on children and youth have been well documented in many domains. However, the impact of pandemic restrictions in child and youth psychiatric inpatient milieux has been largely ignored. This study aimed to understand youth and families' experiences of inpatient psychiatric hospitalization in Canada during the height of the pandemic (2020-2022). We conducted focus groups with youth and family members. Our findings highlight that youth and their kin experienced multiple forms of deprivation, including physical isolation and separation from family. Participants were unanimous in reporting that quality of care was significantly compromised, which they felt led to poorer outcomes. We reflect on the challenges of preserving the relational components of care in a time of crisis, the carcerality of COVID-19 isolation practices, and how the turn toward risk management culture was met with resistance and distrust by youth and their families. We discuss how many findings are reflective of trends in inpatient care overall, not only in times of crisis, and suggest that COVID-19 may have brought into focus fault lines that require a rethinking of child and youth inpatient practices. Nonetheless, the insights from this study can help with guiding policy in future crises, including involving children and families in policy development, reducing potentially traumatizing practices of quarantine and isolation, and maintaining flexibility when applying restrictive regulations to youth mental health patients. (PsycInfo Database Record (c) 2025 APA, all rights reserved).