Adolescent inpatient mental health services in the UK

2021 ◽  
pp. archdischild-2020-321442
Author(s):  
Daniel Hayes ◽  
Jemma Thievendran ◽  
Marinos Kyriakopoulos
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Treatment Plan ◽  
Mental Healthcare ◽  
Inpatient Mental Health ◽  
Adolescent Inpatient ◽  
The Uk ◽  
High Level

Inpatient mental health services are an indispensable part of the mental healthcare for adolescents. They provide comprehensive assessment and treatment for young people severely affected by mental health difficulties whose presentation is associated with high level of risk or where diagnostic clarity and effective intervention cannot be achieved with less intensive community input. In the UK, a range of different mental health units have been developed with the aim to meet the needs of young people requiring admission with the appropriate expertise and in the least restrictive way possible. Although an inpatient admission is necessary and helpful for a number of adolescents, it may also be linked to some adverse effects that need to be carefully assessed and managed when such an option is considered or pursued. Collaborative working between inpatient units, community teams and young people and their families is paramount in ensuring that inpatient interventions form part of a wider treatment plan, are as efficient and effective as possible and are used in a way that fosters engagement, independence and optimal outcomes.

scholarly journals Designing youth mental health services for the 21st century: examples from Australia, Ireland and the UK

2013 ◽  
Vol 202 (s54) ◽  
pp. s30-s35 ◽  
Author(s):  
Patrick McGorry ◽  
Tony Bates ◽  
Max Birchwood
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Mental Disorder ◽  
Age Groups ◽  
Mental Healthcare ◽  
Population Group ◽  
The Uk ◽  
The Impact

SummaryDespite the evidence showing that young people aged 12-25 years have the highest incidence and prevalence of mental illness across the lifespan, and bear a disproportionate share of the burden of disease associated with mental disorder, their access to mental health services is the poorest of all age groups. A major factor contributing to this poor access is the current design of our mental healthcare system, which is manifestly inadequate for the unique developmental and cultural needs of our young people, if we are to reduce the impact of mental disorder on this most vulnerable population group, transformational change and service redesign is necessary. Here, we present three recent and rapidly evolving service structures from Australia, Ireland and the UK that have each worked within their respective healthcare contexts to reorient existing services to provide youth-specific, evidence-based mental healthcare that is both accessible and acceptable to young people.

scholarly journals The divide between child and adult mental health services: points for debate

2013 ◽  
Vol 202 (s54) ◽  
pp. s41-s44 ◽  
Author(s):  
Clare Lamb ◽  
Margaret Murphy
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Discussion Paper ◽  
Adult Mental Health ◽  
The Uk

SummaryThis discussion paper outlines our personal views for debate on some of the complexities inherent in the crucial task of improving mental health services for young people in the UK.

scholarly journals Unexpected deaths of children and young people in the UK

2016 ◽  
Vol 40 (2) ◽  
pp. 68-71 ◽  
Author(s):  
Paul Stallard ◽  
Michelle Maguire ◽  
Justin Daddow ◽  
Rosie Shepperd ◽  
Mike Foster ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Child Death ◽  
National Data ◽  
Children And Young People ◽  
National Health Service Trust ◽  
Incident Reports ◽  
The Uk

Aims and methodTo review the deaths of children and young people who took their own life. We conducted a retrospective analysis of serious incident reports from a National Health Service trust and reviews by the child death overview panels of the local safeguarding children boards.ResultsWe identified 23 deaths, with annual rates varying considerably between local authorities and over time. Over half of the children (n = 13, 56%) were not known to specialist child and adolescent mental health services, with 11 having no contact with any agency at the time of their death. Hanging was the most common method (n = 20, 87%) and of these, half (n =11, 55%) were low-level hangings.Clinical implicationsTraining is required to improve awareness, recognition and the assessment of children at risk of taking their own life. Specialist child mental health services should directly assess plans or attempts at hanging and offer advice about the seriousness of attempting this. National data (by age) on children and young people who take their own life should be routinely published to inform clinical and preventive services.

scholarly journals Mapping UK mental health services for adults with attention-deficit/hyperactivity disorder: national survey with comparison of reporting between three stakeholder groups

BJPsych Open ◽  
2020 ◽  
Vol 6 (4) ◽  
Author(s):  
Anna Price ◽  
Astrid Janssens ◽  
Tamsin Newlove-Delgado ◽  
Helen Eke ◽  
Moli Paul ◽  
...  
Keyword(s):  
Mental Health ◽  
Attention Deficit Hyperactivity Disorder ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Attention Deficit ◽  
Full Range ◽  
Hyperactivity Disorder ◽  
Stakeholder Groups ◽  
The Uk

Background UK clinical guidelines recommend treatment of attention-deficit hyperactivity disorder (ADHD) in adults by suitably qualified clinical teams. However, young people with ADHD attempting the transition from children's to adults’ services experience considerable difficulties in accessing care. Aims To map the mental health services in the UK for adults who have ADHD and compare the reports of key stakeholders (people with ADHD and their carers, health workers, service commissioners). Method A survey about the existence and extent of service provision for adults with ADHD was distributed online and via national organisations (e.g. Royal College of Psychiatrists, the ADHD Foundation). Freedom of information requests were sent to commissioners. Descriptive analysis was used to compare reports from the different stakeholders. Results A total of 294 unique services were identified by 2686 respondents. Of these, 44 (15%) were dedicated adult ADHD services and 99 (34%) were generic adult mental health services. Only 12 dedicated services (27%) provided the full range of treatments recommended by the National Institute for Health and Care Excellence. Only half of the dedicated services (55%) and a minority of other services (7%) were reported by all stakeholder groups (P < 0.001, Fisher's exact test). Conclusions There is geographical variation in the provision of NHS services for adults with ADHD across the UK, as well as limited availability of treatments in the available services. Differences between stakeholder reports raise questions about equitable access. With increasing numbers of young people with ADHD graduating from children's services, developing evidence-based accessible models of care for adults with ADHD remains an urgent policy and commissioning priority.

scholarly journals Incidence of anorexia nervosa in young people in the UK and Ireland: a national surveillance study

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e027339 ◽  
Author(s):  
Hristina Petkova ◽  
Mima Simic ◽  
Dasha Nicholls ◽  
Tamsin Ford ◽  
A Matthew Prina ◽  
...  
Keyword(s):  
Mental Health ◽  
Anorexia Nervosa ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Young Women ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Surveillance Study ◽  
The Uk

ObjectivesThis study aimed to estimate the incidence of DSM5 anorexia nervosa in young people in contact with child and adolescent mental health services in the UK and Ireland.DesignObservational, surveillance study, using the Child and Adolescent Psychiatry Surveillance System, involving monthly reporting by child and adolescent psychiatrists between 1st February 2015 and 30th September 2015.SettingThe study was based in the UK and Ireland.ParticipantsClinician-reported data on young people aged 8–17 in contact with child and adolescent mental health services for a first episode of anorexia nervosa.Main outcome measuresAnnual incidence rates (IRs) estimated as confirmed new cases per 100 000 population at risk.Results305 incident cases of anorexia nervosa were reported over the 8-month surveillance period and assessed as eligible for inclusion. The majority were young women (91%), from England (70%) and of white ethnicity (92%). Mean age was 14.6 years (±1.66) and mean percentage of median expected body mass index for age and sex was 83.23% (±10.99%). The overall IR, adjusted for missing data, was estimated to be 13.68 per 100 000 population (95% CI 12.88 to 14.52), with rates of 25.66 (95% CI 24.09 to 27.30) for young women and 2.28 (95% CI 1.84 to 2.79) for young men. Incidence increased steadily with age, peaking at 15 (57.77, 95% CI 50.41 to 65.90) for young women and 16 (5.14, 95% CI 3.20 to 7.83) for young men. Comparison with earlier estimates suggests IRs for children aged 12 and under have increased over the last 10 years.ConclusionThese results provide new estimates of the incidence of anorexia nervosa in young people. Service providers and commissioners should consider evidence to suggest an increase in incidence in younger children.Trial registration numberISRCTN12676087.

scholarly journals Children and Young People's Improving Access to Psychological Therapies: inspiring innovation or more of the same?

2015 ◽  
Vol 39 (2) ◽  
pp. 57-60 ◽  
Author(s):  
Sami Timimi
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Mental Health Problems ◽  
Children And Young People ◽  
Psychological Therapies ◽  
Common Mental Health Problems ◽  
Uk Government ◽  
The Uk

SummaryIn 2007 the UK Government announced a substantial expansion of funding for psychological therapies for those presenting with common mental health problems. This ‘Improving Access to Psychological Therapies’ (IAPT) project was widely welcomed, however, evidence backed, economic, and conceptual critiques were voiced from the start and the project remains controversial. In 2011, the UK government announced it was extending the IAPT project to encompass services for children and young people with the aim of ‘transforming’ the way mental health services are delivered to them. Here I critically reflect on the problems associated first with IAPT and then with CYP-IAPT and ponder whether CYP-IAPT is significantly different to the problematic adult IAPT project or more of the same.

scholarly journals Inpatient Mental Healthcare before and during the COVID-19 Pandemic

Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1613
Author(s):  
Alan B. McGuire ◽  
Mindy E. Flanagan ◽  
Marina Kukla ◽  
Angela L. Rollins ◽  
Laura J. Myers ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Group Therapy ◽  
Health Services ◽  
Mental Healthcare ◽  
Individual Therapy ◽  
Veterans Health ◽  
Inpatient Mental Health ◽  
Therapeutic Services ◽  
Relapse Rates

Prior studies have demonstrated disruption to outpatient mental health services after the onset of the COVID-19 pandemic. Inpatient mental health services have received less attention. The current study utilized an existing cohort of 33 Veterans Health Affairs (VHA) acute inpatient mental health units to examine disruptions to inpatient services. It further explored the association between patient demographic, clinical, and services variables on relapse rates. Inpatient admissions and therapeutic services (group and individual therapy and peer support) were lower amongst the COVID-19 sample than prior to the onset of COVID-19 while lengths of stay were longer. Relapse rates did not differ between cohorts. Patients with prior emergent services use as well as substance abuse or personality disorder diagnoses were at higher risk for relapse. Receiving group therapy while admitted was associated with lower risk of relapse. Inpatient mental health services saw substantial disruptions across the cohort. Inpatient mental health services, including group therapy, may be an important tool to prevent subsequent relapse.

scholarly journals Creative, participatory projects with young people: Reflections over five years

2017 ◽  
Vol 1 (2) ◽  
pp. 284-299 ◽  
Author(s):  
Valerie J Dunn ◽  
Tom Mellor
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Participatory Research ◽  
Social Care ◽  
Third Sector ◽  
Animated Film ◽  
The Uk ◽  
Transition Preparation

Participatory research is collaborative and democratic, and may be particularly engaging for vulnerable or so-called hard-to-reach groups. In this paper, we describe three creative participatory projects carried out over five years with young people and NHS, social care and third sector partners. Working with young people in care we co-produced a trilogy of films, one of which won the young people a British Film Institute (BFI) award. The films are now used for training throughout the UK. With young people with experience of depression, we coproduced a short, animated film which aimed to offer support to other young people who may be depressed and not know where to turn. Finally, with young people attending or leaving NHS child and adolescent mental health services, we co-produced a transition preparation programme for those leaving the service at 17 or 18. For all the projects, the aim was to maximize involvement and give young people some ownership of the research. We outline our approach and describe some of the challenges and limitations.

Dependency scoring for child and adolescent inpatient mental health services

2005 ◽  
Vol 17 (10) ◽  
pp. 18-21 ◽  
Author(s):  
Peter Hodgkinson ◽  
Emily Watson ◽  
Malli Wadge ◽  
Paul Abeles ◽  
Adam Danquah
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Child And Adolescent ◽  
Inpatient Mental Health ◽  
Adolescent Inpatient

scholarly journals Regional analysis of UK primary care prescribing and adult service referrals for young people with attention-deficit hyperactivity disorder: from little to very little

BJPsych Open ◽  
2020 ◽  
Vol 6 (3) ◽  
Author(s):  
Samuele Cortese
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Attention Deficit Hyperactivity Disorder ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Mental Health Professionals ◽  
Attention Deficit ◽  
Hyperactivity Disorder ◽  
The Uk

Summary Drawing on data from the Clinical Practice Research Datalink, Price et al reported UK regional variations in primary care prescribing and referral rates to adult mental health services for young people with attention-deficit hyperactivity disorder (ADHD) in transition from child and adolescent mental health services. Overall, considering that around 65% of young adults with childhood ADHD present with impairing ADHD symptoms and up to 90% of individuals with ADHD may benefit from ADHD medications, the study by Price et al shows that the rate of appropriate treatment for youngsters in the transition period varies from low to very low across the UK. As such, there is a continuous need for education and training for patients, their families, mental health professionals and commissioners, to eradicate the misconception that, in the majority of the cases, ADHD remits during adolescence and to support the devolvement of appropriate services for the evidence-based management of adult ADHD across the UK.

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