I read Myers et al’s correspondence ^{Reference Myers, Coyle, Kowalski and Srinivasan1} with great interest. I am a consultant child and adolescent psychiatrist working in the forensic child and adolescent mental health services and I am simply dumbfounded by the difficulties that frequently present when trying to coordinate in-patient admissions for young people in Scotland for those who have mental health problems and concurrent risk to others.

Like the authors of the letter, I see the deterioration and the stigma that young people face when admissions are being coordinated. At present, there are no secure mental health beds in Scotland who accept under-18-year-olds. Our only option is to beg for intensive psychiatric care unit beds from colleagues in adult services. I also echo concerns that there is no joined-up bed management system within the service I work for, which means that should I wish to admit a young person, it is up to me to call each unit individually.

Often my only option is to send young people to England, where there are private-sector adolescent medium secure beds. This comes with significant cost, both financial and emotional. I have seen how hard it is for families to agree to send their loved ones so far away, knowing they will struggle to visit or sometimes even telephone. In addition, if a young person is on remand or pre-trial, they cannot be sent across the border.

I thank the authors for making me realise that I am not isolated in this demoralising and stigmatising situation. But this is a bittersweet pill as it only serves to highlight that services need to be made more available for young people across the country.