Adolescents who enter state custody concurrently with a psychiatric hospitalization

Some youth enter state custody concurrently with a psychiatric hospitalization. This can happen when youth have serious emotional disturbances and parents or guardians relinquish custody in order to pay for inpatient psychiatric care. We studied a population of 521 adolescents who entered state custody through the Illinois Department of Children and Family Services (IDCFS) concurrently with a psychiatric hospitalization between our study period from July 2018 to March 2023, and compared them to populations entering state custody in that time period through medical hospitalization and conventional placements. A large majority (79.5 %) of those in the psychiatric hospitalization group entered custody without a finding of parental abuse or neglect or because parents locked out the child, an action some parents take to force the state to take custody Their median length of stay of 56 days suggests that many youth stayed beyond medical necessity. Almost two-thirds went from the psychiatric hospital to a group home or residential treatment center. We discuss how such use of psychiatric hospitalization and congregate care contrasts with policy emphasizing serving youth in the least restrictive setting.