The role of the family in youth psychiatric readmission: a scoping review

Repeated admissions of children and adolescents after inpatient psychiatric treatment point to underrecognized issues in the post-discharge period. The family environment is a promising target for sustained recovery. However, recent systematic reviews on predictors of psychiatric readmission in children and adolescents were unable to synthesize most family-level factors due to conceptual and methodological differences. To address this, we conducted a scoping review following PRISMA-ScR guidelines to (a) synthesize literature on family-related structural and process variables associated with youth psychiatric readmission and (b) identify conceptual and methodological gaps. We included primary and secondary studies in English or German language examining family-related constructs in relation to inpatient readmission. Eighty-three reports retrieved via a multi-tiered search strategy (including PubMed, PsycInfo, Scopus, Web of Science, ProQuest Dissertations & Theses Global, and Google Scholar) were included (79 empirical studies, three study protocols, and one meta-analytic review). Empirical studies have increased in recent years, were primarily conducted in the United States, and largely relied on retrospective or record-based data. Evidence was concentrated on structural characteristics. Among the examined constructs, results linked readmission to indicators of structurally burdened or disrupted caregiving environments (e.g., institutional or foster care), family psychiatric problems (e.g., history of or current psychopathology), and treatment involvement. In contrast, research on specific family processes remains sparse despite their established significance in adult populations. Findings support the relevance of various family factors for youth psychiatric readmission but highlight gaps regarding complex associations, short-term risks, and prospective studies of family processes.