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Thirty-six patient records were examined during site visits to 18 child and adolescent (PH) programs. The documentation of patient assessment and treatment planning was examined. The history of present illness, past psychiatric history, and medical history were at least adequate in about 60-70% of evaluations. Treatment plans were generally complete, but at least one-half of mandated treatment plan reviews lacked revisions. Psychiatric justification of admission and diagnosis was poor in 41% and 44% of charts, respectively, and there was no documentation of ongoing psychiatrist-patient contact in 44% of charts. Possible explanations for these findings include inadequate funding of PH programs, lack of psychiatric time, and uniform approaches to treatment.

Eighteen child and adolescent partial hospital (PH) programs were surveyed through site visits. Demographic and diagnostic characteristics of 796 patients and clinical records of current and discharged patients were examined. Most current patients lived with relatives and 52% received Medicaid. Fifty-eight percent had a primary diagnosis of an externalizing disorder and 46% had been hospitalized. Forty percent of the former patients (N = 96) were discharged from PH when such services were no longer needed; another 36% left because of lack of improvement. Administrative implications of these findings are discussed.