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"Mad" or "bad"? Evaluating the decision to hospitalize SED youth using qualitative data.

This study examines variables associated with positive and negative hospitalization outcomes of seriously emotionally disturbed (SED) youth, and proposes that the context of the decision-making process that takes place before hospitalization plays a role in determining outcomes. Qualitative data from 13 case histories were analyzed to determine the effects of hospitalization after a 2-year follow-up period. Several indicators that have predicted negative outcomes in earlier studies are supported here, including bizarre symptom patterns, educational impairment, and additional hospitalization during the follow-up period. There was agreement in fewer than half of the cases among research clinicians, the subject, or the subject's family regarding the outcome. Findings demonstrate the advantages of qualitative methods in determining the manner in which definitions of mental health influence hospitalization outcomes, suggesting that mental health categories are not a priori categories in the subjects' or families' minds. The social context of the decision to hospitalize is found to be a contributing factor in hospitalization outcomes.