Summary

This document has been produced by a working group of the Faculty of Child and Adolescent Psychiatry and the Faculty of General and Community Psychiatry. It makes recommendations about how services should be provided and commissioned, for the acute care of young people with serious mental illness.

There is widespread recognition that the care of young people presenting with acute, severe mental illness is often unsatisfactory. This can be due to a lack of any suitable bed, undue delay, or an inappropriate admission to an adult or paediatric bed. In fact, some 600 young people are inappropriately placed per year, in England and Wales, on adult or paediatric wards.

The report notes that the principles of specialist provision for adolescents with serious mental illness should include prompt admission, a suitably safe and appropriately staffed ward environment (which conforms to the agreed standards), geographical proximity to the family home (enabling frequent visits and appropriate family interventions to be offered), and minimisation of health and safety risks from other patients and drugs and alcohol availability.

The key recommendations are that:

1. • Young people under 16 years should not be admitted to adult psychiatric wards

2. • Those aged 16 or 17 years of age can be considered for admission to adult psychiatric wards when

   1. • no suitable specialist adolescent psychiatric bed is available

   2. • they are suffering from severe mental illness

   3. • acceptable standards of care are met

3. • Health commissioners need to develop appropriate services

4. • Inappropriate admissions should be considered as a sign of inadequate resources and treated as an untoward or critical incident.

The report concludes that significant investment and development is needed to provide acute inpatient and community services for adolescents with severe mental illness in line with Government priorities.