Rates and correlates of recurrent psychiatric crisis episodes among children and adolescents in state custody

The purpose of this study was to determine the extent of and factors associated with recurrent psychiatric crisis episodes among children and adolescents in state custody. A total of 1362 children ages 3 to 16 years who were in custody of the child welfare agency and underwent a psychiatric crisis screening and services for the first time between 2001 and 2003 were followed for the same observation period of 24 months. Logistic regression was used to determine the clinical and non-clinical factors associated with a return to psychiatric crisis screening and services. Overall, 44.6% of the sample had another psychiatric crisis episode in the following two years. Nearly two thirds of those who returned did so within 6 months of their first crisis episode. A greater likelihood of recidivism was associated with severity of psychiatric illness, being female, white, in residential care placement, and having placement instability. Recurrent psychiatric crises appear to be predictable using readily available variables, which can inform interventions designed to reduce repeat episodes.