Objective: Psychiatric hospital lengths of stay have decreased for children and adolescents, in part because of the presumption that aftercare services in the community are effective and accessible. This review critically examines the literature that pertains to the rates of aftercare service use, the effectiveness of aftercare services, and predictors of aftercare service use.
Methods: Studies were selected on the basis of MEDLINE and PsychINFO computer searches, covering the period between January 1992 and August 2003. Reports that were selected (N=21) included data on outpatient aftercare service use among youths who were aged 18 years and younger and who were discharged from child and adolescent inpatient facilities.
Results and discussion: A majority of youths received aftercare services after hospitalization, but many youths and families were not fully compliant with aftercare recommendations. Many youths and families continued to receive services up to three months after hospitalization. The literature documents only a small amount of evidence about the effectiveness of aftercare services, but the evidence suggested that aftercare services for youths with substance use problems may have beneficial effects. Few studies examined predictors of aftercare service use and discontinuation, but previous recent mental health service use and decreased family dysfunction appeared to be related to aftercare service use.