PC2014: Impact of Novel Writing Exercise for Patients and Staff on an Inpatient Adolescent Psychiatric Unit

Background: Mental health issues such as depression and anxiety are a growing problem in children and adolescents in recent years. In October 2021, the American Academy of Pediatrics declared a national emergency in child and adolescent mental health. Previously we introduced a novel writing exercise, the Three-Minute Mental Makeover (3MMM), which showed short and long-term benefits of stress reduction and enhanced communication for and between patients and practitioners. The goal of this study was to evaluate the short- and long-term impact of the 3MMM for patients and healthcare practitioners on an inpatient adolescent psychiatric unit.

Methods: All patients admitted to an inpatient adolescent psychiatric unit were invited to participate in this single center observational study. The study activities took place over a 6 month period. During the first 3 months there were no changes made to the routine curriculum of care. During the second 3 months of the study, the 3MMM was incorporated into the routine care curriculum. The impact of the 3MMM was compared to routine care on the unit using self-report surveys that inquired about patient-practitioner trust, attitudes about writing, and general mental health status. Surveys were given to patients upon admission to the unit and just prior to discharge. Follow-up surveys were given out both 2 weeks and 6 months after discharge from the unit. The effect of the 3MMM on staff was evaluated using the Maslach Burnout Inventory and a short survey 6 months following discharge of the last patient subject.

Results: A total of 80 patients were included (37 control, 43 intervention). Mean age was 14, 84% females, and 85% were white. Most patients had a diagnosis of major depressive disorder (97 vs 91) and/or generalized anxiety disorder (73 vs 72) and were prescribed medications for mental health treatment (97 vs 91), control vs intervention respectively. There were no differences among how patients answered questionnaires at admission vs discharge among the two groups. Patients in the intervention group were more likely to score “writing about my feelings helps me feel better” higher (p=0.03) on the follow up survey. A total of 8 staff members were evaluated and no statistical difference was found in their emotional exhaustion (2.7 vs 1.9, p=0.38), depersonalization (0.7 vs 0.6, p=0.90), and personal accomplishment (4.4 vs 4.5, p=0.91) Maslach scores, before and after 3MMM respectively. At six months follow up, practitioners had positive comments regarding using this exercise with their patients.

Conclusion: Implementation of the 3MMM as a part of a child’s mental health treatment can improve their attitudes about using writing as a coping mechanism. More research is needed to establish the appropriate context, patient symptom severity, and delivery methods for the 3MMM.