The paediatrician’s role in mental health

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.

Full reference: Davie, M. (2017) The paediatrician’s role in mental health. Paediatrics and Child Health. Published online: 28 July 2017

Children and teens let down by mental health inpatient services in England

Inpatient provision for children and young people with mental health problems. Emily Frith | Education Policy Institute | via OnMedica

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Image source: epi.org.uk

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

Full story at OnMedica

Download full report: Inpatient provision for children and young people with mental health problems.

Patients in long-stay hospitals being neglected in policy and practice

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 struggle to support patients sent far from home for mental healthcare

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

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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.

Read the full article here

Children in UK mental health hospitals ‘not improving’

YoungMinds and the National Autistic Society are launching the Always campaign, which calls for the government to protect and enforce the rights of children in mental health hospitals | YoungMinds

The campaign is based around The Always Charter, which sets out ten rights that young people in inpatient units and their families should always have.

The experience of parents:

Parents who responded to the survey told us: 

“My child has had a number of admissions to different units. The communication and support from these services has been very poor. I have felt guilty, judged, not listened to and belittled.”

“I did challenge some decisions but feel my views were still dismissed and I gave up. The majority of the experience in inpatient was a ‘done to’ rather than ‘with’ approach.”

“We were always asked – ‘Here’s what we recommend. Do you agree?’ – as though it was our choice. But when we didn’t agree, we were seen as obstructive. They said we had choice, but we didn’t.”

“We needed a key contact that all questions about our daughter could be voiced through. Although she had a key worker, she was rarely at the unit or contactable.”

Read the full article here