This study examined adolescents' school adjustment following discharge from a psychiatric hospitalization. Specifically, the first set of analyses examined the provision of support services provided to students prior to his or her psychiatric hospitalization, and changes made following discharge. It was found that, in terms of special education classification, the largest increase occurred in the amount of students classified with an emotional disability. However, 49.4% of the students were still not classified following discharge. With regard to school change, the largest shift occurred in those students who had attended public schools who were then subsequently enrolled in a day treatment or residential program. In terms of counseling services, there was a significant increase in the number of students receiving counseling services from within the school. However, 38.5% of students in this study were still not provided with counseling services within the school following their psychiatric hospitalization.
The second set of analyses examined the relationship between cognitive factors, symptom severity at discharge, and diagnosis of the participants and the subsequent provision of special services following their hospitalization. It was found that students classified with an emotional disability and those with no classification had higher WRAT reading scores than those in the combined LD/ED group. Participant's total symptoms as measured by the SCL-90 and therapist's ratings of paranoia on the HPRS were both related to the provision of any special education services. Participants receiving counseling services were significantly higher on therapist's ratings of participant's interpersonal sensitivity and anxiety symptoms. Diagnosis of the participants were not related to the provision of support services.
The third set of analyses looked at the relationship between participant's cognitive factors, symptom severity at discharge, or diagnosis and outcome measures as measured in four major adjustment areas (academic adjustment, behavioral adjustment, involvement in extracurricular activities, and school attitudes and truancy). Psychotic symptoms at discharge were found to be significantly related to subsequent academic adjustment. Obsessive symptoms were related to later involvement in extracurricular activities. Levels of hostility were negatively related to school attitudes and likelihood for school truancy, and abjection and disinterest was positively related to these factors.
The final set of analyses looked at the relationship between school support services and the four outcome adjustment factors. There was a statistical trend towards the presence of support services predicting behavioral adjustment. Controlling for all other variables, extra time on tests was significantly related to behavioral adjustment. Support services were significantly related to involvement in extracurricular activities, in that those students with support services were less likely to be involved in sports and clubs. Support services were not related to academic adjustment or student's attitudes towards school and truancy.
