Longitudinal relations between parental burden, adolescent externalizing symptoms, and mental health service use in the year following adolescent psychiatric hospitalization.

Rates of adolescent psychiatric hospitalization have increased significantly over the last decade. Despite heightened risk for life-threatening behavior and readmission in the year following hospitalization, mental health service use has varied. Parental burden and youth externalizing behavior have been associated with service use in community samples, with most research focused on children and their parents. The present study explored longitudinal relations between parental burden, externalizing symptoms, and mental health service use in a high-risk clinical adolescent sample in the year following hospitalization. The sample included 252 mothers with an adolescent recently discharged from psychiatric hospitalization. Mothers completed measures of parental burden (Child and Adolescent Impact Assessment), youth externalizing symptoms (Achenbach Child Behavior Checklist), and youth mental health service use (Child and Adolescent Services Assessment) at 1 (M1), 3 (M3), 6 (M6), and 12 (M12) months following adolescent discharge from psychiatric hospitalization. Bidirectional relations between variables were examined with a cross-lagged autoregressive model. Controlling for baseline levels, greater externalizing symptoms were positively associated with parental burden and negatively associated with recommended use of individual psychotherapy over time. Recommended use of youth individual psychotherapy at M3 predicted lower externalizing symptoms at M6. No other longitudinal relations were found. Findings enhance our understanding of the experience of adolescents and families and inform service use patterns during the posthospitalization period. Recommendations for discharge practices and postdischarge care are discussed. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Duke Scholars

Author John F. Curry Psychiatry, Child & Family Mental Health & Community Psychia ...