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C34. Substance Use and Suicidality among Adolescent Psychiatric Inpatients

Substance Use and Suicidality among Adolescent Psychiatric Inpatients

Learner category:

  • Beginning Level
  • Novice Level
  • Intermediate Level
  • Expert Level
Learning objectives:
  • Participants will be able to identify the number one public health problem in the United States
  • Participants will be able to state the associated risks for co-occurring disorders between those with mental disorders, and those with substance use disorders
  • Participants will be able to describe the importance of screening for substance use among adolescent psychiatric inpatients

Abstract:

Adolescent substance use has been identified as our nation’s
number one public health problem. Individuals with mental health
disorders are at increased risk for lifetime prevalence of a substance
use disorder. Conversely, those who use substances are at greater
risk for the development of other mental health disorders. We
examined demographic and clinical characteristics for adolescents,
ages 14-18, admitted to an adolescent inpatient psychiatric unit at a
major Midwestern university medical center over a 3-month period
(September-December, 2019). Among 133 unique admissions,
the majority were white (n=104/131, 79%), female (n=81, 61%), with a
median age of 16 years. Depression was the most frequently listed
first diagnosis (n=80, 60%). The vast majority of all patients endorsed
suicidal ideation (n=108/131, 82%), with females significantly more likely
than males to do so (72/80 [90%] vs 36/51 [71%], p<0.01). Average length
of stay was 7.5 days, with a range of 1 to 28 days. Fully half (n=67/131,
51%) of all adolescent inpatients reported past year use of marijuana
(n=59/131=45%), alcohol (n=36/131, 27%), unprescribed medications
(n=23/131, 18%), and/or other substances (n=11/131, 8%). Males were more
likely than females to have used marijuana (29/52 [56%] vs 28/81 [35%],
p<0.05), and to have clinically significant CRAFFT-2 scores of > 2 (18/41
[44%] vs 16/71 [23%], p<0.05). Those with any past year substance use
were 4.5 times more likely to report suicidal ideation than those who
did not (108/131 [82%] vs 23/131 [18%], p<0.01). These findings reinforce
the importance of screening for substance use among adolescent
psychiatric inpatients

Author(s):

Stephen Strobbe, PhD, RN, PMHCNS-BC, CARN-AP, FIAAN, FAAN
University of Michigan, USA

Dr. Stephen Strobbe is a Clinical Professor at the University of
Michigan School of Nursing, and the Department of Psychiatry.
He is board-certified both in psychiatric and addictions nursing.
His professional background has included clinical care, research,
administration, and education. Dr. Strobbe has authored more than
40 peer-reviewed articles, position statements, book chapters, and
other resources related to substance use and addictions nursing.
He has been an invited speaker, both nationally and internationally,
including the Federated States of Micronesia, Europe, South America,
Southeast Asia, and Iceland. Dr. Strobbe is a former Fulbright Scholar to Brazil (2017-2018), Immediate Past President of the International Nurses Society on Addictions (IntNSA, 2018-2020), a Fellow of the International Academy of Addictions Nursing (FIAAN, 2016), and a Fellow of the American Academy of Nursing (FAAN, 2017).

Jeanette Hokett, MA-ED, BSN, RN, University of Michigan, USA

Jeanette Hokett is the Interim Clinical Nursing Director at the Nyman Family Unit for Child and Adolescent Mental Health and Wellness, and the Child and Adolescent Inpatient Psychiatric Program at C.S. Mott Children’s Hospital, University of Michigan. A member of the American Psychiatric Nurses Association (APNA) and former Member-at-Large for the Michigan State Board of APNA, Ms. Hokett has presented on topics focused on improving care for psychiatric patients and self-care, along with leading and engaging in many quality improvement projects at unit and institutional levels.

Kaitlyn McDonald, University of Michigan

Kaitlyn McDonald is a junior nursing student at the University of Michigan School of Nursing, where she is involved in a clinical quality improvement project to integrate screening, brief intervention, and referral to treatment (SBIRT) for substance use among adolescents . She is currently involved in a Quality Improvement project involving the screening, brief intervention, and referral to treatment (SBIRT) for substance use on the child and adolescent inpatient psychiatric unit at the University of Michigan. Previously, Ms. McDonald participated in research involving nuclear cardiology at the Michigan Medicine Cardiovascular Center. She currently serves as Director of Professional Development in the University of Michigan Chapter of the Student Nurses Association.

Clare Hoerster, University of Michigan

Clare Hoerster is a senior nursing student at the University of Michigan School of Nursing (UMSN). She is a member of the Honors Program at UMSN, where she is involved in a clinical quality improvement project to integrate screening, brief intervention, and referral to treatment (SBIRT) for substance use on the child and adolescent inpatient psychiatric unit at the University of Michigan. Ms. Hoerster is a James B. Angell Scholar at the University of Michigan, and recipient of University Honors. She is an active member of the University of Michigan Chapter of the Student Nurses Association, and serves as a Student Ambassador for both the School of Nursing and the University of Michigan.

Rhonda Schultz, BSN, RN, University of Michigan

Rhonda Schultz is the Educational Nursing Coordinator (ENC) for the Nyman Family Unit for Child and Adolescent Mental Health and Wellness, and the Child and Adolescent Inpatient Psychiatric Program at C.S. Mott Children’s Hospital, University of Michigan. As ENC for the unit, she is responsible for orientation and ongoing education for all unit nursing staff. A certified Non-Abusive Psychological and Physical Intervention (NAPPI) trainer, Ms. Schultz also serves as the unit expert in de-escalation training and has been part of the quality improvement (QI) project team which has helped implement NAPPI throughout Mott Hospital along with other unit-based QI projects.

Jai Ahluwalia
Robert Ploutz-Snyder

Comments (15)

  1. Rita Hanuschock

    Nicely delivered. Question: does Mott Children’s Hospital have a specific unit/program for addiction treatment?

    1. Stephen Strobbe

      Dear Rita,
      Thanks for attending our presentation, and for your question! While the inpatient child and adolescent mental health and wellness unit, from which these data were obtained, is located at C.S.Mott Children’s Hospital, on U-M’s medical campus, the University of Michigan Addiction Treatment Services (UMATS), which includes treatment for adolescents, is part of ambulatory psychiatry at the Rachel Upjohn Building, on the East Ann Arbor Medical Campus.
      Sincerely,
      Dr. Stephen Strobbe

  2. Dene Bellamy

    Dr. Stephen Strobbe, This was an excellent presentation. I like your format by standing beside the presentation. It kelp my attention.
    I plan to look-up your tools (CRAFFT-2 & C-SSRS screening).

    1. Stephen Strobbe

      Dear Dene,
      Thank you for your kind words and positive feedback. As presenters, we were all excited by it, too! All credit for the video goes to our IT department here at the University of Michigan School of Nursing (UMSN), who were delightful to work with. You’ll have no trouble finding these screening tools, as they are broadly employed.
      Sincerely,
      Stephen

  3. Rachel Shuster

    Excellent presentation with such a professional delivery! Thank you!

    1. Stephen Strobbe

      Dear Rachel,
      Thank YOU! Didn’t Katie and Clare do a great job? And remember, these are undergraduate nursing students! The next step is to prepare the manuscript for publication in a peer-reviewed journal, with both of them as co-authors.
      Sincerely,
      Stephen

  4. Oluremi Adejumo

    I enjoyed your presentation. Your recommendation that clinicians should integrate adolescent SBIRT for children and adolescents in the psychiatric ward is highly beneficial. Thank you!

    1. Stephen Strobbe

      Dear Oluremi,
      Thank you attending our presentation, and for your kind words. We appreciate both, and we are glad that you enjoyed, and learned from, our presentation!
      Sincerely,
      Stephen

  5. Donna Walter

    Excellent presentation! Good to hear data that supports the gateway theory as so many practitioners dismiss it.

    1. Stephen Strobbe

      Dear Donna,
      Thank you for attending our presentation, and for your words. Yes, we knew to ask certain questions, and the data replied!
      Sincerely,
      Stephen

  6. Jacqueline Perry

    Great presentation and helpful information. Thank you.

    1. Stephen Strobbe

      Dear Jacqueline,
      You are most welcome! Thank you for attending our presentation, and for your kind words!
      Sincerely,
      Stephen

  7. Cheneen Austin

    Thank you for this presentation. Well presented and I appreciate that you are highlighting our up and coming nurses. Hopefully, this experience will encourage Kaitlyn and Clare to participate in more research!

  8. Marian Laniyan

    This is an important and crucial information for healthcare providers. Thank you for providing is topic.

  9. Phyllis Raynor

    Enjoyed your presentation and I love the focus on adolescents with SBI in inpatient hospitalization.

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