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Substantial reduction in admissions of young people with mental ill health to non-specialist wards

6 October 2016

The number of admissions of young people under 18 in Scotland with mental ill health to non-specialist - mainly adult - hospital wards reduced significantly last year, from 207 to 135. 

The number of young people involved reduced from 176 to 118. The difference between the two figures is due to repeat admissions.

The figures appear in Mental Welfare Commission's latest annual monitoring report, published today, which also includes information by health board area, new data on the duration of stay for young people, and a list of recommendations for further improvement.

The report has an additional six month in-depth study exploring some of the issues behind these admissions.

Colin McKay, chief executive, Mental Welfare Commission, said:

"When young people are so unwell that they need hospital treatment for mental ill health, they should wherever possible be treated in a specialist unit. We were concerned in recent years at the rising numbers who were not receiving this treatment.

"Today's figures show a substantial, and very welcome, drop in the numbers admitted to non-specialist wards. We hope this will be sustained and even improved upon in future.

"The change has come about due to a combination of new beds becoming available, improved intensive community support, and improved processes and more stable staffing in specialist units."

Health boards

Greater Glasgow and Clyde Health Board saw a reduction of 53% in the year.

Grampian Health Board saw a reduction of 44%.

Lothian Health Board's admissions, though small, reduced by 62%.

Areas of concern

While the reductions in admission are very welcome, the Commission did find areas of concern in this year's report.

There are no specialist in-patient services in Scotland for young people with forensic needs or learning disabilities, and these young people sometimes have to be sent to England to receive care. Plans are being developed for new services, and the Commission hopes these will be progressed quickly.

The other significant gap is any specialist intensive psychiatric care provision for young people, who may instead be placed in adult services. While the numbers were low (14 young people), adult intensive psychiatric care units (IPCUs) are highly specialised environments, and clinicians have repeatedly raised concerns with the Commission about the unsuitability of such units for young people.

There was a decrease in the proportions of young people who were able to access age-appropriate recreational facilities while they were in hospital - from 60% the previous year, to only 42% in 2015-16. The report contains a recommendation to address this issue.

Not enough priority was given to addressing educational needs, and young people were not made aware of how to seek independent advocacy. The Commission made recommendations concerning both of these issues.

Additional monitoring

  • The additional monitoring report looked at reasons for admission, and found that over the six month period, over half were due to low mood, suicidal thoughts or self harm. A quarter were due to psychosis.
  • For 51% of admissions, the young person was in a non-specialist setting solely or predominantly because there were no specialist beds available.
  •  While 70% were admitted voluntarily, only 53% of the young people remained voluntary during their stay, meaning 47% were subject to detention at some point during their stay.

Colin McKay said:

"An adult ward can be a difficult and alienating environment for a young person. That is why it is so important that the care is informed by specialist expertise, and the young person has access to age-appropriate recreation and activity.

"For young people staying for more than a few days, and who are well enough, maintaining the link to their ongoing education is also vital, and we are concerned that this may not always be happening."

Note to editors

There are three specialist NHS in-patient units in Scotland for treating young people with mental ill health - in Glasgow, Edinburgh and Dundee.

A copy of the full report can be found on our website.

Young Person Monitoring Report 2015-16

Mary Mowat:  0131 313 8786