A new study has revealed that there has been a 65% rise in the admissions of children and young people to general acute medical wards in English hospitals due to mental health issues between 2012 and 2022.
A new study led by UCL researchers indicates a 65% rise in the number of children and young people being admitted to general acute medical wards in hospitals in England due to mental health issues between 2012 and 2022.
The research, published in the journal The Lancet Child and Adolescent Health and supported by funding from the National Institute for Health and Care Research (NIHR) and the NIHR Great Ormond Street Hospital Biomedical Research Centre (NIHR GOSH BRC), analyzed data on hospital admissions of children aged 5 to 18 years from April 1, 2012, to March 31, 2022.
General acute medical wards are specialized areas in hospitals that provide quick evaluation, treatment, and care for patients. These wards connect emergency departments, general practitioners, and other hospital services, but are distinct from specialized mental health facilities like eating disorder clinics.
Children and young people typically come to these wards from Accident and Emergency departments because their health condition is too severe, or it is unsafe for them to return home.
The researchers discovered that over the decade, admissions related to mental health increased from 24,198 to 39,925, marking a significant 65% rise. In contrast, all-cause admissions only grew by 10.1%, from 311,067 to 342,511.
The increase in admissions was particularly pronounced among girls aged 11 to 15, whose cases soared from 9,091 to 19,349, representing a 112.8% increase. Additionally, admissions for eating disorders surged from 478 to 2,938, reflecting a staggering 514.6% rise.
This research is the first to explore national trends concerning mental health admissions of children and young people to acute medical wards. The analysis included both children’s and adult wards for individuals up to 18 years of age.
Dr. Lee Hudson, the study’s senior author from the UCL Great Ormond Street Institute of Child Health and Great Ormond Street Hospital, stated, “Over the past ten years, we’ve seen a considerable increase in mental health admissions among young people in acute medical wards. While attention has been given to the rising referrals to community mental health services and inpatient settings, the role of general acute medical wards is a key aspect that needs more focus.”
“These wards are vital in caring for young people facing mental health challenges, particularly when they also struggle with physical health issues, such as malnutrition caused by an eating disorder.”
However, Dr. Hudson noted that this increasing demand poses significant challenges for acute medical wards, impacting both patients and their families, as well as the staff caring for them. Sometimes these facilities aren’t equipped with the right environment for such care, and staff may require more training to effectively manage these cases. This calls for improved collaboration between physical and mental health professionals across hospital and community services, including providing sufficient support from psychiatrists and trained mental health nurses on the wards.
While the study could not determine the exact causes of the sharp rise in mental health admissions from national data, researchers are currently working on gathering more detailed information on the reasons behind admissions from selected children’s wards in England. They also aim to interview young patients, their families, and the ward staff to gain further insights.
Dr. Hudson elaborated, “On a broader scale, we are all trying to comprehend why more young people are experiencing mental health struggles. It’s likely related to the overall prevalence of mental health issues, along with possibly escalated severity in individual cases leading to more hospital admissions when patients can’t safely return home.”
“Our findings indicate that the rise in admissions is not solely due to the COVID-19 pandemic, as there have been continual increases since 2012. This situation has become a critical aspect of acute wards, and it won’t simply resolve itself; thus, enhancing care is imperative. We hope this study and our ongoing research will aid in this regard.”
“Moreover, it’s crucial to identify the factors that contribute to these admissions to better support the mental health of young patients.”
A recent report from the Health Services Safety Investigations Body (HSSIB), an independent organization focused on patient safety, raised various concerns linked to these admissions. For instance, 13 out of 18 pediatric units surveyed characterized their environments as “not safe” for children and young people facing high-risk behaviors due to mental health issues.
Concerns included insufficient resources for therapeutic activities, challenges posed by the physical ward layout, difficulties in managing patients needing sedation, and worries about how these admissions might affect the well-being of other patients and the morale of staff. Efforts are underway across the country to address these challenges, and researchers anticipate that their study will underscore the urgent need for improved integration of acute medical, mental health, and social care services in support of children and young people admitted for mental health reasons.
By enhancing coordination and planning, they hope to ensure that young patients receive the thorough care required, both during their hospital stay and in the community.
Study limitations
The limitations of the study include the potential undercounting of mental health admissions due to inconsistencies in diagnostic coding and the inability to assess the level of care or use of the Mental Health Act. Moreover, the study could not differentiate between admissions to pediatric or adult wards or account for alterations in admission standards during the pandemic.
Further research, part of the MAPS project, is currently underway to collect more detailed data regarding admissions at specific hospitals in England and conduct interviews with children, families, and staff to fill in these informational gaps.
