A Scoping Review of Dissociation in Child and Adolescent Acute Inpatient Mental Health Care

Acute or emergency inpatient mental health care may be used during a mental health crisis to ensure a young person's safety and to assist with stabilization of behavioral and emotional concerns. Many young people who present for acute inpatient care display symptoms of dissociation that are not necessarily identified or targeted during the admission, but that nonetheless affect clinical care and outcomes. This scoping review synthesizes the empirical literature on dissociative symptoms and disorders within acute inpatient child and adolescent mental health settings. Database and hand searches identified both quantitative research (n = 36) and case studies (n = 17). Rates of dissociative disorders and clinically significant dissociative symptoms, co-occurring disorders and trauma histories, and associated safety concerns (e.g., self-harm, suicidality, harm to others) among inpatient youth are presented. A summary of case studies outlines the assessment and treatment of dissociation among young people on inpatient units, including the role of multidisciplinary care, behaviour management, psychotherapy, pharmacotherapy, and family involvement. Implications for improving clinical care are discussed.