According to a new study, young people in urgent need of mental health beds often wait long periods in general hospital acute care before being placed in facilities that are far from their homes.
Conducted by experts from the University of Nottingham, the study found that over 40% of young people had to wait seven days or longer for admission to a youth psychiatric department, with the majority waiting in general hospitals such as children’s or general medicine wards or the emergency department.
The study, published in BMJ Mental Health, examined the admission of young people to psychiatric facilities that are far from their homes. This includes a general psychiatric facility for youth more than 50 miles away from home or in a different NHS region, or an adult psychiatric unit. More than half of the young people admitted to facilities that were 50 to 100 miles from home, with the majority remaining in the same facility throughout their admission. At a six-month follow-up, 20% were still in the hospital.
Dr. Josephine Holland, from the University of Nottingham’s School of Medicine, was one of the lead authors of the study. She said, „Young people are waiting a long time for a psychiatric bed, something those we studied considered to be an urgent need. This forces them to wait in places that are not entirely suitable for a young person in a mental health crisis.“
Our study’s findings also show that remote admission contributed to delays in discharge in over a third of cases. A longer hospital stay means more time without family, friends, and school. The fact that over a third of these young people had delayed discharge meant they were even further apart from these important support networks,“ said Professor Kapil Sayal, also from the School of Medicine and lead author of the study.
Professor Kapil Sayal, lead author of the study
Clinical risk was often a significant factor in these admissions, with 80% of admissions presenting a suicide risk. Depression was the most common diagnosis among those admitted, with over half showing significant emotional regulation difficulties and a fifth being diagnosed with psychosis.
The study collected data from the Royal College of Psychiatrists‘ monitoring system for child and adolescent psychiatry. The team gathered information on 290 admissions of 13- to 17-year-olds to general youth departments (i.e., a general psychiatric ward for under 18s), far from home (more than 50 miles away or in a different NHS region), or to adult psychiatric units between February 2021 and February 2022.
The data showed that over a fifth of young people waited for more than ten days for a bed, with an additional 18% waiting seven to ten days. Only nine percent of young people waited less than a day for a bed. The majority of these young people waited in general hospitals (40% in the children’s ward, 8% in the adult ward, and 7% in the emergency department). One in ten (11%) had to wait in Section 136 suites—a specialized facility usually located in an adult psychiatric hospital designed to hold people for no longer than 24 hours while awaiting assessment under the Mental Health Act.
Professor Kapil Sayal added, „In the future, the development of service models aimed at improving care in mental health crisis situations in the community, and more intensive therapeutic input for young people waiting in general hospitals, could help address some of the challenges highlighted by our study.“
The study was funded by the NIHR ARC East Midlands, which supports crucial work to address the region’s health and care priorities by accelerating the introduction of cutting-edge research in health and social care. It introduces evidence-based innovations aimed at improving care standards and saving time and money.