Eating disorders affect more than 5% of young people, and they have one of the highest mortality rates of any mental illness.
Young patients with public health insurance have a much harder time accessing care, and they often get caught in a revolving door of hospital stays.
Researchers at UC San Francisco wondered if the cycle could be disrupted by giving outpatient therapy in the months after a first hospitalization.
They examined data from 920 California Medicaid enrollees ages 7 to 18 years old who had been hospitalized with an eating disorder.
These young patients received on average just two outpatient therapy sessions after leaving the hospital, and nearly half (45%) received none at all.
Therapy, when delivered, was provided by community-based clinicians rather than specialty clinics.
What They Discovered:
Those who received eight or more therapy sessions were 25 times less likely to be readmitted than those who received 3 or fewer sessions.
Outpatient providers don’t need to be specialists or experts in eating disorders to help young people with these conditions stay out of the hospital.
California’s Medicaid program (Medi-Cal) would save more than $7 million annually in rehospitalizations alone if adolescents could access eight or more sessions of outpatient therapy after hospital discharge for eating disorders.
Why It Matters:
Hospitalization can be especially challenging for families on Medicaid.
“Caregivers are more likely to be single parents with less flexible work schedules and fewer financial resources to cover out-of-pocket expenses,” said first author Megan Mikhail, PhD.
“The findings suggest a modest amount of outpatient therapy from any type of provider can help break the cycle of repeat hospitalizations,” said senior author Erin Accurso, PhD.
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Publication: Pediatrics (July 25, 2025) Other Authors: Amanda Downey, MD, of UCSF; Kate Duggento Cordell, PhD, of Mental Health Data Alliance; Lonnie Snowden, PhD, of UC Berkeley. Funding and Disclosures: Accurso has consulted with Partnership HealthPlan of California. The study was supported by the Deb Family and a grant from the National Institute of Mental Health (NIMH K23 MH120347; ECA). |
About UCSF: The University of California, San Francisco (UCSF) is exclusively focused on the health sciences and is dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. UCSF Health, which serves as UCSF's primary academic medical center, includes top-ranked specialty hospitals and other clinical programs, and has affiliations throughout the Bay Area. UCSF School of Medicine also has a regional campus in Fresno. Learn more at ucsf.edu, or see our Fact Sheet.
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