Mental health is increasingly acknowledged as an integral part of a paediatrician’s work. This article aims to cover six important areas that will be useful to the general paediatrician | Paediatrics and Child Health
In the first part of the article I will tackle: why mental health is an important part of paediatric care, what kind of mental health difficulties do children encounter and how should paediatricians initially approach emotional and behavioural problems? In the second part I will describe the emotional problems encountered in paediatric services, how to understand behavioural problems and how to manage both of these in paediatric practice. Practical approaches and advice are provided in each section.
Inpatient provision for children and young people with mental health problems. Emily Frith | Education Policy Institute | via OnMedica
A report from the Education Policy Institute has found that 12% of child mental health inpatient units failed to meet basic requirements for staff to patient ratios.
Nearly a quarter (24%) of units struggle to employ permanent staff – up from 17% since 2014/15. Temporary bank and agency staff make up 19% of child mental health inpatient pay costs.
Staff shortages affect the quality of patient care, so a sustained focus on recruitment of skilled staff to work in child and adolescent mental health services is needed, recommends the report.
The report also found:
inpatient mental health services for young people on average fail to meet 7% of minimum quality of care standards
The issue of bed shortages can mean that children with mental health problems are admitted to adult wards
Eating disorders were the most common reason for a young person being admitted to hospital in 2015/16
Young people are being left in hospital for longer than necessary due to a lack of community services with the trend getting worse – the number of delayed discharge days in December 2016 – February 2017 42% higher than in the same period the previous year
People with long-term mental health needs are facing stays of many years in inpatient services because of a lack of community services to help them to recover | Centre for Mental Health
Long-stay rehabilitation services, by Emily Wright, reviews evidence from Care Quality Commission inspection reports of inpatient rehabilitation services in England. It finds that while many people receive high quality care close to home from rehabilitation services, a minority spend periods of many months and sometimes years in hospital. Some are placed far from home in locked wards and become isolated from their families and dislocated from their local health and care services.
GPs warn they are struggling to support young patients with mental illness after BMA research found seven in 10 children and adolescents with severe mental health problems were admitted to hospitals outside their local area | GPonline
A total of 69% of child and adolescent admissions for severe mental health issues in 2016/17 were classed as ‘out of area’, according to data obtained from hospitals by the BMA.
Figures obtained under the Freedom of Information Act show that the proportion of children admitted to hospital out of their area rose 12 percentage points in 2016/17 compared with the previous year.
The BMA warned that the figures – published to coincide with Mental Health Awareness Week – showed worsening access to specialist beds.