The Premature Demise of Public Child and Adolescent Inpatient Psychiatric Beds

Abstract

Psychiatric disorders are the leading reason for hospitalization among 5-19 year olds. Current data, however, suggest there are fewer than necessary available services for children and adolescents requiring intensive, inpatient psychiatric care. Children and adolescents with behavioral health problems, the majority of whom do not receive appropriate treatment, have increased risk of school failure, family disruption, out-of-home placements, poor employment opportunities, and poverty in adulthood. This paper will examine the challenges inherent in serving children and adolescents with serious emotional disturbances, avenues of financing for treatment and services, and various loci of intervention for high-risk children, including inpatient settings and systems of care. The goals of this paper are to illustrate the complexities of working with children and adolescents most in need of intensive psychiatric services, to explore how inpatient services "fit" into existing treatment approaches, and to discuss the efficacy of downsizing or closing inpatient psychiatric units for this population.

On being a client with posttraumatic stress disorder: Interactions with treatment providers and institutional barriers

“…They shared that they are instructed to seek emergency services when they are suicidal; but, when they seek services, they may be turned away and feel dismissed by the ER staff due to a lack of hospital beds and resources. This is consistent with literature across many types of psychopathology (Geller & Biebel, 2006; Glasby & Lester, 2005).…”

Why do Adolescents Return to an Acute Psychiatric Unit?

“…9 Furthermore, adolescent psychiatric beds cost the health service more than adult psychiatric beds. 10,11…”

Staff Experience, Knowledge and Attitudes Regarding the Management of Adolescent Patients in Adult Mental Health Units

“…The majority of staff who completed the survey had experience looking after such patients and the concerns that they raised are consistent with those previously identified in the literature. 1,5–8,11 Respondents were generally not in favour of adolescents being managed in adult units apart from in exceptional circumstances. Overall, staff believed that such units were ill equipped to care for adolescent patients, that the objectives of an admission were frequently unmet, and that a specific child and adolescent unit would be preferable.…”