Healthcare (Commonwealth Union) – A recent study led by UCL researchers reveals a significant 65% rise in the number of children and adolescents admitted to general acute medical wards in England due to mental health issues between 2012 and 2022.
Published in The Lancet Child & Adolescent Health journal and funded by the National Institute for Health and Care Research (NIHR) and the NIHR Great Ormond Street Hospital Biomedical Research Centre (NIHR GOSH BRC), the study analyzed data from 2012 to 2022 on all medical ward admissions of children and young people aged 5 to 18 in England.
General acute medical wards are specialized units designed to provide immediate assessment, treatment, and care, often acting as a bridge between emergency departments, general practitioners, and other hospital wards. These wards differ from specialized mental health facilities like eating disorder units.
Young patients are typically admitted to general medical wards from Accident and Emergency when they are too ill or unsafe to return home. The research found that in the past decade, admissions related to mental health increased from 24,198 to 39,925, reflecting a 65% rise. In comparison, total admissions for all causes saw a modest 10.1% increase, from 311,067 to 342,511.
The rise was particularly prominent among girls aged 11-15, whose admissions doubled from 9,091 to 19,349 (an increase of 112.8%), and a notable spike in admissions due to eating disorders, which soared by 514.6%, from 478 to 2,938.
This study is the first to examine national trends regarding mental health admissions to acute medical wards for children and young people, encompassing both pediatric and adult medical wards for patients up to age 18.
Senior author Dr. Lee Hudson of UCL Great Ormond Street Institute of Child Health indicated that they have seen a considerable rise in mental health-related admissions to acute medical wards over the past decade. He further indicated that while there has been much focus on increased mental health service referrals and inpatient care, admissions to general acute wards have not received as much attention in the discussion.
“Acute medical wards are important places for caring for young people with mental health concerns – especially those with co-existing physical health problems like starvation from an eating disorder.
“However, the increased intensity we describe is presenting real challenges for acute wards, both for patients and their families and the staff supporting them. They may not be set up with an appropriate ward environment for this care, and sometimes staff working there need more training and support with relevant skills. This calls for better co-working between physical and mental health professionals across hospital and community teams, including, for example, adequate provision of psychiatrists and mental health trained nurses to support physical medical care on the actual ward.”
The researchers were unable to identify the exact causes behind the significant rise in mental health-related hospital admissions from the national data alone. However, they are now gathering more detailed information from a sample of children’s wards in England, along with conducting interviews with young patients, their families, and ward staff.
Through this, they aim to gain a clearer understanding of the factors contributing to these admissions and develop more targeted and effective interventions.
Dr. Hudson indicated, that on a broader scale, we are all working to understand why more young people are struggling with their mental health. It’s likely that the increasing prevalence of mental health issues, combined with possibly more severe cases, is driving the rise in emergency hospital admissions, where it is unsafe for patients to return home.
Researchers of the study indicated that the study may have underestimated the number of mental health admissions because of differences in how diagnoses were coded. It also couldn’t provide details about the intensity of care or how the Mental Health Act was applied.
