Working together better for mental health in children and young people during a pandemic: experiences from North Central London during the first wave of COVID-19

Abstract

Direct risk from infection from COVID-19 for children and young people (CYP) is low, but impact on services, education and mental health (so-called collateral damage) appears to have been more significant. In North Central London (NCL) during the first wave of the pandemic, in response to the needs and demands for adults with COVID-19, general paediatric wards in acute hospitals and some paediatric emergency departments were closed. Paediatric mental health services in NCL mental health services were reconfigured. Here we describe process and lessons learnt from a collaboration between physical and mental health services to provide care for CYP presenting in mental health crisis. Two new ‘hubs’ were created to coordinate crisis presentations in the region and to link community mental health teams with emergency departments. All CYP requiring a paediatric admission in the first wave were diverted to Great Ormond Street Hospital, a specialist children’s hospital in NCL, and a new ward for CYP mental health crisis admissions was created. This brought together a multidisciplinary team of mental health and physical health professionals. The most common reason for admission to the ward was following a suicide attempt (n=17, 43%). Patients were of higher acute mental health complexity than usually admitted to the hospital, with some CYP needing an extended period of assessment. In this review, we describe the challenges and key lessons learnt for the development of this new ward setting that involved such factors as leadership, training and also new governance processes. We also report some personal perspectives from the professionals involved. Our review provides perspective and experience that can inform how CYP with mental health admissions can be managed in paediatric medical settings.

Suicide spectrum among young people during the COVID-19 pandemic: A systematic review and meta-analysis

“…1 , 47 studies were included in the systematic review (study characteristics are reported in Table 1 ). 32 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 Among these studies, 43 were included in the meta-analytical process, for a total of around 65 million subjects (suicides: 63,120,235; suicidal behaviors: 934,951; suicidal ideation: 156,234): two reporting rates of deaths for suicides, 48 , 50 26 reporting prevalence data about suicidal behaviors 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 <...…”

Digital and Hybrid Pediatric and Youth Mental Health Program Implementation Challenges During the Pandemic: Literature Review With a Knowledge Translation and Theoretical Lens Analysis

“…Thus, implementing programs in schools should maximize accessibility for all students. A case study analysis in the United Kingdom of youth in wards (N=36) found that it was challenging to implement a youth mental health ward in a pediatric setting, which required setting up a new ward and combining physical health with mental health [ 27 ]. They also found that it required joint efforts in a multidisciplinary team setting involving nurses and pediatric psychiatrists, which led to adopting new leadership and managerial approaches as well as tailoring treatments to individual patients [ 27 ].…”

“…Most of the articles explicitly described that the study was implemented during the COVID-19 pandemic in their titles [9,[19][20][21][22]24,[26][27][28]30,[32][33][34][35][36][37][38][39][40][41][42]44]. Others discussed their study relevance in relation to the COVID-19 pandemic in the abstract or main text [9,23,29,31,38,39].…”

‘They could not see our eyes, they cannot see our faces, they do not know who we are and that is hard’: a qualitative interview study with staff caring for children and families in a UK specialist children’s hospital during the COVID-19 pandemic

“…We planned to admit young people up to age 25 to reduce the burden on adult centres; this did not happen. But we did admit a wider than usual range of referrals from across the region and created a new ward for acute children and young people’s mental health admissions who would not previously have come to our hospital 18…”

“…But we did admit a wider than usual range of referrals from across the region and created a new ward for acute children and young people’s mental health admissions who would not previously have come to our hospital. 18 …”