The Scottish Children’s Services Coalition (SCSC), an alliance of leading independent and third sector providers of children’s services, is urging the Scottish Government to "up its game" in response to a report from the Mental Welfare Commission out today (17th March).
The report indicates that the number of young people under the age of 18 (PDF) admitted to non-specialist hospital wards - mainly adult wards - for treatment of their mental illness rose for the third year running. There were 118 admissions involving 101 young people in 2018/19.
This is an increase on the 2017/18 figures which saw 103 admissions involving 90 young people and a further increase from 2016/17 when there were 71 admissions involving 66 young people.1
Admission of a young person to an adult ward should only be acceptable in rare situations.
However, despite a greatly increased demand on mental health services, there are currently only 48 specialist hospital beds provided by the NHS in Scotland for children and young people (aged 12 to 18) with mental health problems.
These beds are in three child and adolescent mental health services (CAMHS) inpatient units (Dundee, Edinburgh and Glasgow) and there is a further six-place unit for those aged five to 12 in the Royal Hospital for Sick Children in Glasgow. There is no inpatient provision north of Dundee.
Given the lack of provision, many children and young people with severe mental health problems are therefore being admitted to non-specialist adult and paediatric hospital wards, settings which are in many cases inappropriate to their needs.
The coalition has urged the Scottish Government to ensure that there are adequate specialist bed numbers that can address need, including provision north of Dundee. It has also called on it to refocus its efforts on prevention and early intervention, ensuring that issues do not escalate so that they require the provision of these specialist services.
The coalition has echoed the Mental Welfare Commissions' call called for intensive psychiatric care facilities for children and young people with mental health illnesses, of which there are currently none in Scotland.
Under the Mental Health (Care and Treatment (Scotland) Act 2003 health boards are required to provide appropriate services and accommodation for young people admitted to hospital for treatment of their mental disorder.
Given admissions to non-specialist mental health wards, it is clearly arguable whether appropriate services are being provided.
There are a number of differences between specialist units and wards designed to treat the needs of adults with serious mental illness, both in terms of staff training and the overall ward environment. Given this, there is a clear concern that the needs of a young person may not be met in a comparable way when admitted to an adult mental health ward as opposed to a specialist CAMHS inpatient unit.
A spokesperson for the Scottish Children’s Services Coalition commented:
“We are clearly concerned about the increasing number of those being admitted to adult mental health wards, often inappropriate to their needs, both in terms of staff training and the ward environment. The Scottish Government needs to up its game on this and provide adequate facilities, ensuring that there are sufficient specialist bed numbers for those requiring them. There is also currently no provision north of Dundee and this requires to be urgently addressed.
“For children and young people who require inpatient mental health care, a lack of such services means that they frequently remain at home, often until the family reaches crisis point, leaving them feeling isolated and delaying recovery.
“These are among the most vulnerable members of our society and we owe it to them to give them the adequate care and support that they need.”