Fifth of child mental health admissions to adult units

Programme for Government in 2011 stated intention to abolish practice

Minister of State for Primary Care Kathleen Lynch said efforts needed to be sustained to continue reducing child admissions to adult units. Photograph: Eric Luke

Minister of State for Primary Care Kathleen Lynch said efforts needed to be sustained to continue reducing child admissions to adult units. Photograph: Eric Luke

 

One in five of all admissions of children to mental health institutions is made to an adult unit, in spite of Government promises to end the practice, a new report shows.

Eighty-nine children were admitted to adult units last year, compared to 98 in 2013, according to the annual report of the Mental Health Commission.

Chairman John Saunders described the situation as unacceptable and pointed out that in most cases, vacancies existed in child and adolescent mental health service (CAMHS) unit.

The 2011 Programme for Government states: “We will endeavour to end the practice of placing children and adolescents in adult psychiatric wards”.

In December 2011, the official code of practice relating to admission of children under the Mental Health Act 2001 came into effect. It states that apart from exceptional circumstances, “no child is to be admitted to the adult unit of a psychiatric hospital”.

The reasons why children continue to be admitted to adult units aren’t entirely clear but factors include geography and parental preference, the lack of a 24-hour specialist service for children and bed management issues in CAMHS units.

Of 15 children who were involuntarily detained last year by order of the courts, nine were sent to adult units.

Minister of State for Primary Care Kathleen Lynch said efforts needed to be sustained to continue reducing child admissions to adult units. The HSE had recently “refocused” initiatives to achieve further improvements.

The commission said it was disappointing that only three out of 61 adult and child mental health centres were fully compliant with regulations almost a decade after they were introduced. The three centres are the Sycamore Unit of Connolly Hospital, Willow Grove Adolescent Unit at St Patrick’s Hospital in Dublin and St Edmundsbury Hospital in Lucan.

Compliance with regulations dropped last year after a period of improvement and there was a 73 per cent increase in the number of serious concerns over 2013. Many of these related to care plans and medication issues.

However, the number of mental health patients accommodating in hospitals dating from the Victorian era continues to drop and the remaining four, which includes the Central Mental Hospital, are expected to close within two years.

Mr Saunders said the commission was concerned by the decline in compliance with codes of practice governing the admission, transfer and discharge of patients. “This situation points to the need for a more coherent, responsive bed management policy and perhaps a review of the required number of beds.”

Welcoming the report, Ms Lynch said the Government was committed to modernising the mental health services and had provided an additional €125 million and 1,150 posts to develop services.

Mr Saunders said new posts had been replaced largely in new, smaller units but this was more than offset by the lost of staff in the older institutions. Overall, the mental health sector had seen a “drainage” of 25 per cent of posts.