Impact of young people's admissions to adult mental health wards in England : national qualitative study

Abstract

BACKGROUND: National policy in England recommends that young people be admitted to mental health wards that are age-appropriate. Despite this, young people continue to be admitted to adult wards. AIMS: To explore the impact of young people's admissions to adult wards, from the perspectives of young people, parents/carers and mental health professionals working in adult services. METHOD: Semi-structured interviews were conducted with 29 participants to explore experiences of receiving and delivering care in adult mental health wards. Participants were four young people (aged 16-17 years), four parents/carers and 21 mental health professionals from adult mental health services in England. Data were analysed using framework analysis. RESULTS: Young people's admissions to adult wards tend to occur out of hours, at a time of crisis and when no suitable adolescent bed is available. Admissions were conceptualised as a short-term safety measure rather than for any therapeutic input. Concerns were raised about safeguarding, limited treatment options and a lack of education provision for young people on adult wards. However, exceptionally, for older adolescents, an adult ward might be clinically or socially appropriate. Recommendations to reduce adult ward admissions included better integration of adolescent and adult services, having more flexible policies and increasing community provision. CONCLUSIONS: Our findings emphasise the importance of young people being admitted to age-appropriate in-patient facilities. Earlier intervention and increased provision of specialist care in the community could prevent young people's admissions to adult wards.