Date of Award

January 2024

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Andrés Martin

Abstract

School reentry after inpatient psychiatric hospitalization requires careful coordination between multiple stakeholders to ensure stability across transitions, given the documented potential for negative academic and socioemotional impacts in the post-discharge period. Existing studies of lived experiences of school reentry after psychiatric hospitalization are limited, and no study examines the perspectives of multiple stakeholders from the child’s home, school, and psychiatric experiences simultaneously. This study aims to characterizes the dynamics between children and adults in the transition process, to better inform future school-hospital-family partnerships. We conducted a qualitative study based on semi-structured interviews, and utilizing purposive recruitment to assess a spectrum of educational experiences. For each child interviewed, we recruited adults from home, school, and the hospital. Individual interviews occurred via video teleconferencing, with concurrent data analysis toward a grounded theory born of thematic analysis. Across 16 interviews, we analyzed perspectives from 17 related participants (three quartets and one quintet): four children, four parents, five school staff, and four hospital staff. Student profiles include first-time vs multiple admissions and the presence or absence of adequate special education services. We identified four key themes in service of an overarching grounded theory: 1) Centering the socioemotional role of school; 2) Clarifying what constitutes good communication; 3) Reconciling multiple sources of authority; and 4) Navigating limitations with creativity. Together, these themes converge into the theoretical concepts of stereovision and patchworking. Stereovision represents the synthesis of multiple stakeholder perspectives or “lines of sight,” which cross to create a densely interactional system. When represented schematically, the crossed perspectives appear similar to threads in a fabric, a fitting metaphor for the safety net woven by teams to support a child in transition. Patchworking represents the creative problem-solving and makeshift pathways utilized by participants, the cobbling together of case-by-case solutions to develop an adequate support plan in the face of multiple limitations or barriers. In conclusion, by incorporating the above four thematic findings into a novel grounded theory, we argue that when navigating school reentry after psychiatric hospitalization, children and adults must use stereovision and patchworking to create a strong, flexible support fabric. These reflections increase representation of child and adult stakeholder voices in the literature and inform future school-hospital-family partnerships for school reentry after psychiatric hospitalization.

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This is an Open Access Thesis.

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