1st November 2022
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Increase in children treated on adult psychiatric wards
After a drop over several years in the numbers of children admitted to adult wards, the numbers have begun to rise steeply again
“The end state is: we can’t do anything right now that feels safe enough to keep them at home, so we need to admit them. And they are going into beds that are not at all appropriate for them.” Dr Elaine Lockhart, chair of the Child and Adolescent Faculty at the Royal College of Psychiatrists
More and more children with mental health problems are being treated on adult psychiatric wards, according to new figures from the Care Quality Commission.
In 2021-22, there were 249 admissions of under-18s to adult psychiatric wards in England, an increase of 30% on the previous year. Of those, 58% were cases where the child needed to be admitted immediately for their safety. In a quarter of cases, however, the child was admitted to the adult ward because there was no alternative child inpatient or community outreach service available.
Dr Elaine Lockhart, chair of the Child and Adolescent Faculty at the Royal College of Psychiatrists, said the figures were “a concern but not a surprise. We’ve got a lot of children and young people who have become more unwell. Services are really struggling to meet their needs.”
She said that mental health services across the country were facing a “perfect storm” as a result of “patchy” provision of intensive treatment services in the community and insufficient funding for early intervention: “The end state is: we can’t do anything right now that feels safe enough to keep them at home, so we need to admit them. And they are going into beds that are not at all appropriate for them.”
Steep rise in children needing mental health treatment
Fifteen years ago, the government set a target to end inappropriate admissions of children to adult psychiatric wards. The numbers fell for some years, but have now risen again, the CQC data suggests.
NHS England said that children should only be admitted to adult wards as a “last resort” and that although the CQC figures showed an annual rise, such admissions had dropped in the last quarter despite “record demand”.
In the past two years, the number of children needing mental health treatment has risen steeply, with those waiting for routine treatment between January and March 2022 increasing by 21% over the last year. Two-thirds (66%) of the 1,697 under-18s had been waiting longer than the four-week target. The rise in demand for treatment for eating disorders has been particularly dramatic.
The mental health charity Young Minds said the figures showed the burden on the health care system was “unsustainable” and that improvements were needed “not only to inpatient care but also to community services that help prevent young people becoming so ill that they need to be hospitalised”. Olly Parker, the charity’s head of external affairs, added that being placed on an adult ward could be traumatic for children who were already extremely unwell and make “a frightening situation even worse. This cannot go on,” he said.
FCC Insight
These figures from the CQC are immensely worrying. After several years when the NHS was successfully reducing the number of child admissions to adult psychiatric words, the trend has been reversed. This is in large part the result of a big increase in mental health problems among the under-18s, including a rise in eating disorders – potentially exacerbated by the pandemic. As well as improving the resources available to treat children and young people, we also need to look at better strategies for supporting them before they reach the stage of needing crisis help, such as the free mental wellbeing services recently launched in Harrow. Creating environments which offer support in the community and at school are crucial. Budgets are likely to be cut in the coming months, but health and care should be supported in this time.
