There is probably a consensus that psychiatric hospitalization for children and adolescents should be part of a continuum of care, but that given its expense and unnatural nature (children should be with families in a community), as noted by Kyriakopoulos in this issue, it should be used sparingly. Child psychiatrists in both the United States (McClellan) and the United Kingdom (Cotgrove and Northover) rue the fact that resources spent on inpatient units would be better spent on preventing hospitalization or providing better aftercare. It is certainly easy to see that the significant financial cost of a child’s inpatient stay might well pay for his or her psychiatric treatment in the community for a year – assuming there were enough well‐trained clinicians and resources to provide it. As we describe below, that is the rate‐limiting step to providing alternatives and may account for why treatment is centralized rather than kept in communities. Hamdani et al eloquently describe the situation in low‐ and middle‐income countries where there is a dearth of both inpatient and community resources; requiring urgent attention to the provision of holistic care for young people with mental health problems from preventive services upwards. The approach they describe is what our other authors are calling for, due to an historical over‐reliance on inpatient beds in higher income countries.

中文翻译：

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社论：我们需要住院病房吗？

可能有一个共识，即儿童和青少年的精神病住院治疗应该是连续护理的一部分，但鉴于其费用和不自然的性质（儿童应该与社区中的家人在一起），正如 Kyriakopoulos 在本期中指出的那样，它应该谨慎使用。美国 (McClellan) 和英国 (Cotgrove 和 Northover) 的儿童精神科医生都认为，在住院病房上花费的资源最好用于预防住院或提供更好的善后护理。很容易看出，如果有足够训练有素的临床医生和资源来提供，儿童住院治疗的巨额财务费用可能足以支付他或她在社区接受一年的精神病治疗。正如我们在下面描述的，这是提供替代方案的限速步骤，可能解释了为什么集中治疗而不是保留在社区中。Hamdani 等人雄辩地描述了缺乏住院和社区资源的低收入和中等收入国家的情况；需要紧急关注为有心理健康问题的年轻人提供从预防服务向上的整体护理。由于历史上高收入国家对住院病床的过度依赖，他们描述的方法正是我们其他作者所呼吁的。迫切需要关注为有心理健康问题的年轻人提供从预防服务向上的整体护理。由于历史上高收入国家对住院病床的过度依赖，他们描述的方法正是我们其他作者所呼吁的。需要紧急关注为有心理健康问题的年轻人提供从预防服务向上的整体护理。由于历史上高收入国家对住院病床的过度依赖，他们描述的方法正是我们其他作者所呼吁的。