A Parent’s Guide: What to Do After a Mental Health Hospitalization

Hospitalization for a mental illness stabilizes the patient. This is a crucial element of care because it quickly transitions a patient from an unhealthy, potentially dangerous state to one that is more manageable. It takes away much of the risk that the individual will harm himself or someone else.

While this crisis stabilization is important, it’s only the beginning of care. A follow-up after hospitalization for mental illness and ongoing treatment is essential for several reasons:

• Follow-up care helps patients maintain stable functioning
• Gains made during inpatient care are more likely to be kept with follow-up treatment
• Ongoing treatments and follow-up care reduce and delay hospitalizations in the future
• Failure to seek a follow up can worsen psychiatric symptoms

Not receiving ongoing care can also increase the risk of related negative outcomes, like substance abuse, homelessness, violence, and suicide.

Parents can play a big role in ensuring their adult son or daughter receives follow-up care following stabilization in a hospital or psychiatric unit. They should take the necessary steps to get follow-up appointments scheduled immediately.

First, it is essential to open discussions about aftercare right away. Parents need to begin the discussion with hospital social workers and case managers about what comes next. They should insist on making a plan and having an appointment in place as soon as possible. Studies show that patients who have a follow-up in the seven days after discharge are more likely to use ongoing services and to stick with their medications. This is as compared to patients only had a follow-up appointment within the first 30 days.

Once that initial follow-up appointment is made, it is important for the parents to be sure their adult child attends it. Parents can provide reminders or actual transportation to the appointment to ensure it isn’t missed.

Finally, one follow-up visit is not adequate for most patients who have been hospitalized for mental illness. It should be a launching point for a plan that includes ongoing care. Residential treatment is one of the best options for long-term wellness because it allows patients to focus on and learn good self-care, coping strategies, and life skills.

Parents can be a big part of making sure this happens, engaging with caregivers and their son or daughter to make a plan for the future, setting appointments, activating reminders, and helping them get to their appointments every time.

Disengagement from ongoing mental health care is not uncommon. About one-third of patients with serious mental illnesses will disengage at some point, skipping appointments, not going to see healthcare professionals at all, or just failing to take advantage of services or get involved in care.

Patients may step back from care for several reasons, including that they don’t feel it’s helping, they don’t think they need it, or they are not getting effective collaborative care. Studies have found that actively involving the patient in communication and treatment decisions is effective in increasing personal agency and motivating greater engagement.

Parents can help keep their adult children engaged or prevent disengagement by actively including them in decisions. Instead of directing, parents partner with their children to promote involvement. Some other actionable and proven effective strategies for increasing follow up and ongoing engagement in care include:

• Making follow-up appointments as soon after hospitalization as possible
• Ensuring the hospital staff makes it clear what aftercare will entail and why it is important
• Reminding patients of appointments with regular contact
• A meeting between the patient and the outpatient care provider before being discharged from the hospital
• Visiting a residential treatment facility before discharge

Parents should be aware if their son or daughter falls into a higher risk group—that is, patients who are at the greatest risk of failing to go to follow-up appointments or to disengage to any degree with treatment. These include patients with both mental illness and a substance use disorder and those with more severe mental illnesses, like schizophrenia.

There are studied and effective strategies and programs that help increase retention and engagement in ongoing care for these kinds of patients. They include critical time intervention (CTI) and assertive community treatment (ACT).

First designed for homeless patients, CTI has been adapted for all kinds of medium-risk patients in transition. CTI lasts for a few months and includes strategies that help tie the patient to service providers and support groups, increase emotional support, and offer practical services like transportation and life skills training. ACT is for higher-risk patients, is more intensive, and provides multidisciplinary interventions in the patient’s home.

Parents who believe their adult children are at a higher risk of not engaging in or failing to get involved in follow-up care can get them involved in a program like CTI or ACT. The patient’s doctors should be able to point parents to these kinds of programs or the professionals who provide similar services.

Hospitalization is distressing for patients and their families. It’s a necessary first step in treating mental illness, with or without substance misuse, but it is not the end of care. Repeated hospitalizations are likely if a patient does not receive follow-up care after psychiatric hospitalization. Patients alone are likely to struggle to make appointments or stay engaged in this follow-up care, and parents can play a big role in maintaining ongoing treatment.