Adolescents at risk of school dropout: Is scholar intervention within an adolescent psychiatric department a therapeutic option?

Background: Although school dropout is not a psychiatric diagnosis, it is a frequent concern for child psychiatrists, and covers a variety of psychopathological situations. In addition, severe psychopathologies in adolescence also constitute a risk of school dropout, hence undermining the prognosis. Integrating care into the issue of dropping out of school seems like an interesting lead. Since 2008 we have reorganized the partnership between the specialized hospital care system and the detached school group in our hospital to meet these increasing demands. Here we propose to reevaluate the first 50 patients who benefited from this device, to assess their clinical situation at discharge (t1) and at 30 months (t2) and to explore the factors potentially associated with their reinsertion. Methods: Socio-demographic and clinical variables were retrospectively collected at t0 and t1. Regarding evaluation at t2, the data were obtained by telephone call. The retained criteria for reintegration at 30 months are: the resumption of schooling (classical, adapted, or medico-social type) or the existence of a professional activity. Results: Between 2008 and 2012, we received 52 subjects (36 boys, 69%) in the hospital's educational system in combination with consultation (n = 20) or day hospitalization (n = 32). They had miscellaneous psychopathological profiles. In total, 37 were pupils (71%) and the average period of school absence was 6.7 months. The average duration of care in the care plan was 4 months. At age 30 months, 34 subjects (65%) had school rehabilitation with significant overall clinical improvement (30% increase in EGF score). Only the existence of an educational measure at t0 and the clinical severity (CGI-S and EGF) at t1 was significantly associated with poor reinsertion at t2. Conclusion: Adolescents at risk of dropping out of school have benefited from the system in terms of psychosocial adjustment and reintegration into school. Although psychopathological profiles were diverse, the only prognostic factor was the existence of a child protection measure.