Addressing Chronic School Absenteeism Through Intensive Home-Based Psychiatric Treatment: An Examination of the IICAPS Program

Youth enrolled in intensive home-based treatments (IHBT) often present with concurrent mental health issues, complex multigenerational trauma, and broad psychosocial adversity that impacts functioning, including their ability to attend school. These young people stand to benefit from the protective factors associated with successfully adapting to school, including better mental and physical health outcomes in adulthood. This study examined the prevalence, clinical presentations, and treatment trajectories of chronically absent youth participating in the Yale IICAPS IHBT program in Connecticut. This study is a retrospective descriptive examination of records from 932 youth from the Yale IICAPS program. Two subgroups of youth were identified based on parental identification of school attendance as a clinical concern or not. Rates of absence, clinical diagnosis, severity and functioning, and treatment trajectories of these two groups were examined. More than one-third of youth (n = 362) were chronically absent, but a minority of parents (36%) identified school absences as a core concern at intake. All youth with chronic absenteeism experienced reduced school days absent during IICAPS treatment. However, those not explicitly identified by parents with attendance as a core concern at intake experienced a significantly greater improvement in attendance (38% reduction in days absent vs. 17%). Although potentially helpful in improving school attendance for all youth, the differential treatment effect observed in this study could indicate that IHBT are particularly well suited to addressing familial and system aspects of chronic school absenteeism among high-risk youth.