Can inpatient psychiatric care help teens amid a depressive crisis?
There has been a troubling rise in adolescent mental health struggles and suicide rates over the past decade, with a dramatic increase following the start of the COVID-19 pandemic. This crisis has been accompanied by an increased demand for pediatric inpatient psychiatry units (IPUs) across the United States. However, despite the growing need, which has reached the point of bed shortages, the effectiveness of IPUs on teen mental health outcomes remains understudied.
This study, led by Dr. Patricia Ibeziako from Boston Children’s Hospital, reviewed the electronic medical records and self-report questionnaires of over 200 adolescents (ages 12–17) admitted to the IPU between September 2021 and September 2023. Their study was published in the journal Psychiatric Research and Clinical Practice on April 21, 2025. They found one of the highest lifetime rates of suicide attempts ever reported in adolescents, with more than 75% of teens reporting at least one suicide attempt in their lifetime. Furthermore, nearly 70% of participants reported having suicidal thoughts within two weeks before admission, highlighting the severity of this mental health crisis. Depression was the most common diagnosis, with 93% of adolescents meeting the diagnostic criteria. This was often accompanied by other conditions such as anxiety disorders, attention deficit hyperactivity disorder, and trauma-related disorders.
At the hospital, the teens received daily care from doctors, therapists, nurses, and counsellors. They also had access to group therapy, school support, and help with any physical health problems. The team used special tools to assess suicide risk and conduct safety planning. They also used proven therapies like Cognitive Behavioural Therapy (CBT) and Dialectical Behaviour Therapy (DBT), which are known to help people with depression and suicidal thoughts.
Most importantly, the study focused on the teens’ own voices by using Patient-Reported Outcomes (PROs)—surveys that asked the teens how they were feeling and functioning. This helped the care team understand what was working and what needed more attention.
But despite the high severity of symptoms upon admission, the study found that the patients showed significant improvement by the time they were discharged. “Self-reported measures on depression, anxiety, emotional regulation, family functioning, and overall life satisfaction all improved significantly”, says Dr. Ibeziako. “In fact, the largest treatment effect was seen in depressive symptoms, and improvements were observed across all subscales of depression, including mood, suicidal ideation, and energy levels.”
Perhaps most strikingly, the study found that adolescent scores for suicidal thoughts decreased by more than half. “The implementation of enhanced suicide screening and treatment that aligns with the Zero Suicide framework has made a meaningful difference in these young people’s lives," adds Dr. Ibeziako. This framework, which was introduced during the first year of the pandemic, takes a comprehensive, system-wide approach to suicide prevention. The findings showed that when paired with other treatments for depression, the intervention led to significant improvements in symptoms and emotional regulation. “Pediatric IPUs play a crucial role in delivering these life-saving interventions,” emphasizes Dr. Ibeziako.
The results of this study show that timely and targeted psychiatric care can be lifesaving. With adolescent depression and suicidal thoughts at an all-time high, these results are a clear call to action for healthcare systems to prioritize resources and access to pediatric IPUs and further research into their outcomes.
Reference:
Patricia Ibeziako, Inpatient Psychiatry Patient Reported Outcomes: Adolescent Emotional Distress, Suicidal Thoughts and Behaviors, Psychiatric Research and Clinical Practice, https://doi.org/10.1176/appi.prcp.20240127.
