School Supports for Reintegration Following a Suicide-Related Crisis: A Mixed Methods Study Informing Hospital Recommendations for Schools During Discharge

Navigating Through the Darkness: An Exploratory Study Unraveling the Experience of Hospitalization of Adolescents and Their Caregivers Amid Suicidal Presentations

Suicide prevention and treatment guidelines for pediatric patients often mirror adult strategies. Distinguishing itself from other pediatric specialties, when a child is psychiatrically hospitalized, the child is typically separated from their family, despite the impact and possible ramifications of familial separation. This exploratory study explores the perceived impact of inpatient psychiatric treatment, through patient and caregiver narratives, aiming to enhance mental health treatment approaches. Focusing on the experience of 19 adolescent and parent dyads, we conducted thematic analysis of their interviews. Participants highlighted their hospital experience across two key categories: emergency department and hospitalization experience, including personal and social impacts of their stay. Findings are explored in the context of the helpfulness-harmfulness paradox and suggest that understanding these experiences from both adolescent and caregiver perspectives can inform improvements in psychiatric treatment practices. Despite limited research on optimal practices for acute psychiatric episodes, this study underscores the importance of considering the broader familial and emotional impacts of hospitalization.

Potential Harms of Responding to Youth Suicide Risk in Schools

The potential harms related to interventions for adults with suicide-related risk, particularly hospitalization, have been well documented. Much less work has focused on the potential harms related to interventions with youth struggling with suicidal thoughts and behaviors. Young people are most likely to receive mental health services in schools, which are recognized as meaningful sites for effective suicide prevention work. However, no overviews have conceptualized the potential harms to youth when schools engage in ineffective suicide prevention efforts. In this article, we discuss three prominent overlapping areas of potential harms: (1) privacy-related, (2) relationship-related, and (3) mental health-related. We then discuss key factors thought to influence the development and maintenance of these potential harms. We conclude by noting ways in which school-based mental health providers may attempt to reduce unintentional harms in this area, with an overarching goal of helping support school mental health providers and the youth they serve.

Collaborating to support school reintegration following suicide-related crises: Voices from the field

Adolescent psychiatric hospitalization for suicide-related crises continues to rise. Although previous reviews have identified frameworks for supporting youth as they return to school settings, there is a need to identify and address barriers to collaboration across hospitals and schools. This qualitative study explored school and hospital professional perspectives to inform a pathway toward partnership for improving practices for school reintegration. As part of a larger project that has been developing guidelines for adolescent school reintegration following psychiatric hospitalization for suicide-related crises, the present study explored professional perceptions of (a) school interactions during hospital stays and (b) recommendations for adolescents, families, school professionals, and hospital professionals. We conducted in-depth interviews with 19 school professionals and seven hospital professionals and analyzed transcribed interviews using Applied Thematic Analysis. Communication and collaboration emerged as cross-cutting themes across research questions, with additional themes considered across a continuum of care. Findings inform the ways in which professionals can collaborate to support adolescent recovery, spanning universal approaches implemented in advance of a crisis to approaches enacted during and following psychiatric care. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Training School Staff to Support Students Returning to School After A Psychiatric Hospitalization

Supporting students returning to school after a mental health crisis often involves more training than many school staff members receive. With the increase in youth mental health diagnoses, there has also been an increase in the number of youth requiring psychiatric emergency department visits and hospitalizations. As such, this study employed a basic qualitative design to gather the perspectives of school staff who support students' mental health about their experiences and training needs related to supporting youth returning to school after psychiatric hospitalization. Semi-structured interviews were conducted with 10 school mental health professionals or administrators. Thematic analysis was used to analyze the data. Three themes were identified: 1) most participants received minimal formal training in graduate school on hospital to school transition, 2) most participants learned about hospital to school transition on the job, and 3) participants made recommendations and identified specific training needs. Implications for training are discussed including a need for variety (e.g., some practitioners need basic training while others need more advanced training) and different format preferences (in-person may be preferred but online asynchronous is more convenient).

Practice experiences for school reintegration: Endorsement for virtual reality with adolescents hospitalized for suicide-related crises

This study applied qualitative methods and a user design approach to develop and iteratively refine a model for a virtual reality intervention designed to supplement standard inpatient treatment for adolescents hospitalized for suicide-related crises: the practice experiences for school reintegration (PrESR). The PrESR model allows patients to practice therapeutic skills within an immersive school environment to increase skill knowledge and skill use and to improve school reintegration. Adolescents previously hospitalized for suicide-related thoughts and behaviors (n = 13), hospital professionals with experience providing supports to hospitalized adolescents (n = 7), and school professionals with experience supporting adolescents with suicide-related risks (n = 12) completed focus group and/or one-on-one interviews to inform the development of the PrESR model. Transcribed interviews were analyzed using content analysis, and structured feedback was analyzed by calculating frequencies. Participating adolescents were between the ages of 13 and 18, identifying their race as White (61%), Asian (7.7%), American Indian and Black (7.7%), or Black (7.7%; note that 15.4% preferred not to answer) and their ethnicity as Hispanic (23%) or non-Hispanic (77%). Adolescents identified their gender as girl or woman (46%), boy or man (38%), or "some other way" (15%). A majority of adolescent and professional participants endorsed the PrESR as holding the potential to promote skill learning. Feedback addressed improvements to scenarios and skills; safety concerns, constraints to consider, and barriers to implementation; and information to include in the treatment manual. Findings also informed the types of difficulties adolescents face in schools and the potential feasibility of a virtual reality intervention to enhance standard inpatient care of adolescents hospitalized for suicide-related crises. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Information sharing between psychiatric hospitals and schools to better support adolescents returning to school following a suicide-related crisis

As rates of adolescent hospitalization for suicide-related crises increase, so does the urgency for improving adolescent school reintegration. Communication and collaboration are considered key mechanisms for continuity of care during times of transition; however, to date, few studies have identified critical information to share or have explored strategies for navigating challenges to information sharing during and following school reintegration. The present study explored previously hospitalized adolescent (n = 19), parent (n = 19), school professional (n = 19), and hospital professional (n = 19) views of information sharing and their perceptions of facilitators and barriers to this communication. Applied thematic analysis revealed three key themes related to the best information to share across entities, including the (a) need to consider environmental relevance to information (i.e., informing school supports and hospital treatment), (b) importance of considering information unique to each patient's circumstance (i.e., sharing information on a "case-by-case basis"), and (c) duality between families preferring to share minimal information but school professionals desiring the maximum (i.e., less is more vs. more is better). Regarding facilitators and barriers to information sharing, six key themes emerged, including (a) understanding risks and benefits of information sharing; (b) trust in hospitals and schools; (c) mental health stigma; (d) communication processes; (e) navigating individual, family, school, and community contexts; and (f) "push and pull" between privacy and need. Findings inform key considerations for collaborating with families in determining if and what information to share during school reintegration.

An Empty Scoping Review of Emergency Department to School Transition for Youth with Mental Health Concerns

The number of youth Emergency Department (ED) visits due to mental health concerns has been steadily increasing with a large number of youth being referred from school. Despite the increase in ED visits, there has not been an increase in the number of students who are actually admitted to the hospital. Further, youth referred from school are more likely to be discharged from the ED. Given the unique relationship between school and ED referrals and the large number of youth who do not require hospitalization, this study sought to understand how schools are supporting students who return to school after an ED visit. We conducted a scoping review to identify programs and practices to support ED to school transition. Two reviewers screened 907 manuscripts, but none of the manuscripts met the inclusion criteria. We discuss the importance of supporting students returning to school from the ED and draw from the literature on hospital to school transition to make recommendations for educators.

Supportive Transition Planning for Adolescents Transitioning From Psychiatric Hospitalization to School: A Systematic Literature Review and Framework of Practices

School-aged youth with behavioral health needs often struggle in the academic environment. When admitted to acute psychiatric hospital settings, the student's difficulties and needs increase upon discharge and return to the school setting. While the literature describes systemic issues in transitioning from an acute psychiatric hospital to the school setting, limited resources exist for practitioners to plan for and support the successful reintegration of affected students. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the purpose of the current systematic review was to collect and synthesize evidence from the literature (N = 20) in the areas of barriers, challenges, and significance of the need for a formal transition planning framework. Four major key factors emerged as important to assist in creating a transition planning framework for acute psychiatric hospitals to school-based settings: (a) Stakeholder Voice (Student, Caregiver, Hospital/Treatment Team, or School Team Voice); (b) Establishing a Point Person for Transition (Medical or School Point Person); (c) Recommendations/Accommodations (Formal or Informal Supports); and (d) Having a Transition Meeting. Other common factors are discussed, and recommendations are provided to aid practitioners in increasing the likelihood that school-age youth succeed in the school environment post-discharge from acute psychiatric settings. Finally, gaps in the literature are identified as areas for further research.

Adolescent, parent, and provider perspectives on school-related influences of mental health in adolescents with suicide-related thoughts and behaviors

Previous research supports a link between school-related factors, such as bullying and school connectedness, and suicidal thoughts and behaviors. To deepen understanding of how school experiences may function as both protective and risk factors for youth struggling with suicidal thoughts and behaviors, this qualitative study explored multiple perspectives. Specifically, in-depth interviews were conducted with adolescents previously hospitalized for a suicidal crisis (n = 19), their parents (n = 19), and the professionals they may interact with in schools and hospitals (i.e., school professionals [n = 19] and hospital providers [n = 7]). Data were analyzed using applied thematic analysis revealing three main themes related to perceptions of how school experiences can positively or negatively impact mental health, including (a) school activities, (b) school social experiences, and (c) school interventions. An emergent theme related to the complexity of suicide-related risk identified the ways in which school experiences may intersect with other environmental, biological, and psychological factors. Findings underscore the need for school-based approaches to address the unique academic, social, and emotional needs of students with suicide-related risk that complement the supports and services provided in their home and community.