Outpatient therapy offers hope for young eating disorder patients after hospitalization

Eating disorders affect more than 5% of young people, and they have one of the highest mortality rates of any mental illness. 

Young patients with public health insurance have a much harder time accessing care, and they often get caught in a revolving door of hospital stays. 

Researchers at UC San Francisco wondered if the cycle could be disrupted by giving outpatient therapy in the months after a first hospitalization. 

They examined data from 920 California Medicaid enrollees ages 7 to 18 years old who had been hospitalized with an eating disorder. 

These young patients received on average just two outpatient therapy sessions after leaving the hospital, and nearly half (45%) received none at all.

Therapy, when delivered, was provided by community-based clinicians rather than specialty clinics.

What they discovered:

Those who received eight or more therapy sessions were 25 times less likely to be readmitted than those who received 3 or fewer sessions. 

Outpatient providers don't need to be specialists or experts in eating disorders to help young people with these conditions stay out of the hospital.

California's Medicaid program (Medi-Cal) would save more than $7 million annually in rehospitalizations alone if adolescents could access eight or more sessions of outpatient therapy after hospital discharge for eating disorders. 

Why it matters:

Hospitalization can be especially challenging for families on Medicaid. 

"Caregivers are more likely to be single parents with less flexible work schedules and fewer financial resources to cover out-of-pocket expenses."

Megan Mikhail, PhD, Study First Author and Postdoctoral Clinical Psychology Fellow, University of California - San Francisco

"The findings suggest a modest amount of outpatient therapy from any type of provider can help break the cycle of repeat hospitalizations," said senior author Erin Accurso, PhD.