Factors Associated with Follow-Up Mental Health Care After Psychiatric Hospitalization Among Medicaid-Enrolled Children and Youth

<title>Abstract</title> <p>U.S. authorities have urged health and human service systems to address the escalating youth mental health crisis, which requires timely identification of service gaps and targeted, data-informed intervention strategies. This study utilized cross-sector, individual-level administrative data from the State of Rhode Island to examine factors associated with receiving follow-up care after a psychiatric hospitalization among Medicaid-enrolled children and youth. The study population included 5,258 children and youth aged 0–24 with an inpatient discharge for a primary diagnosis of mental illness between January 2017 and November 2022. The outcome was receipt of outpatient, intensive outpatient, or partial hospitalization services with a mental health provider during the month after hospitalization. Logistic regression models showed significantly lower odds of receiving minimally adequate follow-up care for transition age youth (OR 0.72) as well as those who recently experienced a pregnancy (OR 0.45), juvenile justice involvement (OR 0.58), parental substance use history (OR 0.76), or household job loss (OR 0.79). In contrast, those with longer hospitalizations; primary diagnoses related to depression, anxiety, or schizophrenia; and a parent recently engaging in mental health services were more likely to receive follow-up care. These results offer actionable insights for system-level planning and suggest where focused efforts may improve continuity of care for children and youth in need of mental health services. Findings also underscore the value of integrated administrative data for identifying high-need subpopulations and informing strategies to improve mental health services. Further implications for practice and policy are discussed.</p>