A young person’s sense of self-worth can affect their treatment for mental health issues, which could be a problem for many patients, according to a new study.

Researchers found that youths receiving inpatient help had poorer self-concept than those getting help on an outpatient basis, based on an analysis of the self-perceptions of a few dozen adolescents between ages 8 and 17. A study in the Journal of the Canadian Academy of Child and Adolescent Psychiatry reported that the inpatient subjects had reduced self-worth and did not like themselves as much as the outpatient youths.

According to the study, self-concept among the inpatient group, as measured on the Self-Perception Profile for Children and Adolescents, was “significantly compromised.”

“Inpatients often minimize their own positive attributes and strengths, making it difficult to accept positive feedback,” the authors wrote in their paper. “Individuals with psychiatric disorder, particularly internalizing problems, have dysfunctional negative views of themselves, their life experience, and their future.”

They note that it is possible that inpatients showed lower self-worth because they have more severe mental health problems than outpatients to begin with.

Overall, young people getting psychiatric treatment of both types tend to have reduced self-concept as compared to the rest of the population.

The authors call for more research into the discrepancy between inpatient and outpatient groups and for experts to modify treatment in order to make up for the loss of self-worth seen in inpatient settings.

“This was the first study that examined youth with psychiatric disorder by comparing what type of service they were receiving and whether that was associated with self-concept,” researcher Mark Ferro said in a statement from the University of Waterloo. “We know that global self-worth is lower in the inpatient group and we know from other research that lower self-concept is a precursor to other more serious mental health problems.”

According to Ferro, psychiatric facilities could work to improve self-esteem during the course of standard mental health treatment.

“Because youths who are in the inpatient service have a lower self-concept, therapies within their overall treatment program aiming to improve self-worth might be worthwhile,” he said. “Interventions to improve an individual’s self-concept or self-perception would be complementary to some of the more pressing needs within child and youth inpatient psychiatric services.”