Distribution and characteristics of in-patient child and adolescent mental health services in England and Wales

Abstract

BackgroundLittle is known about the current state of provision of child and adolescent mental health service in-patient units in the UK.AimsTo describe the full number, distribution and key characteristics of child and adolescent psychiatric in-patient units in England and Wales.MethodFollowing identification of units, data were collected by a postal general survey with telephone follow-up.ResultsEighty units were identified; these provided 900 beds, of which 244 (27%) were managed by the independent sector. Units are unevenly distributed, with a concentration of beds in London and the south-east of England. The independent sector, which manages a high proportion of specialist services and eating disorder units in particular, accentuates this uneven distribution. Nearly two-thirds of units reported that they would not accept emergency admissions.ConclusionsA national approach is needed to the planning and commissioning of this specialist service.

A randomised controlled multicentre trial of treatments for adolescent anorexia nervosa including assessment of cost-effectiveness and patient acceptability – the TOuCAN trial

“…11 The brief was an important one because of the extremely high cost of inpatient care, 35,61 when stays commonly last several months and when AN makes a major demand on adolescent inpatient services. 5 The facility to offer long-term psychiatric (as opposed to medical) treatment in the UK has often been highly valued, clinical intuition suggesting that more intensive treatments should be more effective than briefer, non-specialist treatment for a condition that is often chronic and has a high morbidity and mortality.…”

“…Anorexia nervosa is currently the most prevalent disorder within inpatient child and adolescent mental health services. 5 It is thought that eating disorders may have changed over time, particularly in the increasing ratio of the purging form of AN to the restricting form. Anorexia nervosa used to be seen as a middle-class disorder of the white, western world.…”

The characteristics and activities of child and adolescent mental health services in Italy: a regional survey

“…To our knowledge, the only study to date on this topic was conducted in England and Wales, to assess the distribution and few key characteristics of psychiatric inpatient units [14]. The only other studies available on mental health services for children and adolescents have focused mostly on costs [15], historical functioning and staff data [16], inpatient care effectiveness [17,18], service utilisation and provision [19,20], treatment intensity [21], and on determinants of unmet needs [22].…”

“…Concerning inpatient facilities, a nationwide study conducted in England [14] found a range of available beds throughout the nation (3.4-12.9 beds per 100,000 population aged 18 yrs. and younger) which was close to the rate observed in the present study (5 per 100,000).…”

Çocuk ve Ergenlerin Yatarak Tedavisinde İyileşme Ne Kadar Kalıcı Oluyor?

“…Bu servislerin çocuk ve ergen ruh sa¤l›¤› bütüncül yaklafl›mlar›nda önemli bir unsur oldu¤u vurgulanm›flt›r (2,3). Ancak yatarak tedavi gören çocuk ve ergenlerin uzun dönem faydalan›mlar›, sosyal ve emosyonel uyumlar› konusunda halen çok az fley bilinmektedir.…”