Nearly 20% of adolescents in the U.S. are diagnosed with mental illness each year, 10% including a serious emotional or behavioral disorder (Preyde et al., 2011). With the prevalence and severity of adolescent mental illness on the rise, it is worth devoting close scrutiny to the efficacy of different programs available to treat these youth. One type of program in need of review is the short-term, youth crisis residential program (CRP), which boasts a relatively high success rate. This paper will explore the different elements that collectively make CRPs successful for youth with mental illness, comparing and contrasting the current literature with qualitative findings from my field study. Common elements included a structured environment, family-focused approach, cooperation, and a positive focus. Implications of these findings are discussed in terms of generalizing to other treatment programs and areas in need of future research and support from the academic community.
Fieldwork was conducted primarily at the CSP Youth Shelter in Laguna Beach, California. Additionally, fieldwork was conducted while accompanying shelter residents on outings to parks, recreation centers, community workshops, and similar events.
Data were collected qualitatively in the form of extensive fieldnotes, over the course of 10 weeks. The data were then coded and analyzed to determine the primary elements crucial to the success of CRPs.
Throughout the course of my 10-week study, I observed approximately 20 youths aged 13-17. In order to be admitted to the shelter, youths must be “in crisis,” characterized by “behaviors or a history indicative of SED [serious emotional disturbance], experiencing significant familial conflict, and at-risk of hospitalization and/or out-of-home placement” (“Childrens Shelters”, n.d.). Youths met a range of diagnoses under the DSM-IV-TR, including mood disorders and personality disorders, with and without psychotic features. Depressive symptoms and behavioral problems were especially common.
Preyde et al. (2011) conducted a longitudinal study comparing the long-term outcomes of youth with severe mental health problems who received residential treatment (RT) with those who received intensive home-based treatment (IHT). In this study, key elements of RT included a highly structured environment, cooperative group living, individual therapy, social skills training, and family therapy. Limitations of RT include the possibility of deviancy training, inadequate discharge and reintegration n plans, a focus on child as individual rather than as a part of the family system, and a lack of family involvement. Preyde et al. sought to compare RT with IHT, an alternative that is similarly as intensive as RT, but less restrictive, allowing youth to live at home and continue attending their school. Although this is an appealing treatment option, IHT is also limited, in that it...