Growing number of children placed in adult mental-health facilities

Increase in child admissions shows ‘stark failure to abide by established policy’

Mental Health Commission chairman John Saunders: children have very specific mental health needs which are not provided for in adult units. Photograph: Alan Betson

Mental Health Commission chairman John Saunders: children have very specific mental health needs which are not provided for in adult units. Photograph: Alan Betson

 

Just 6 per cent of mental health units were compliant with staffing regulations last year and an increasing number of children are being placed in units designed for adults as a result, the Mental Health Commission has said.

A total of 44 children were admitted to adult mental health units in the first five months of this year, up from 36 in the same period a year earlier.

In its annual report, the commission says the increase in child admissions shows a “stark failure to abide by established policy”. The issue needs to be urgently addressed by the Government and the HSE, it says.

The trend of children in adult units was attributed to a fall in the number of beds available to the Child and Adolescent Mental Health Services (CAMHS), which the commission says came about due to a shortage of qualified personnel to staff them.

Geography, clinical decisions and family preference were also put forward as factors in the rise of child admissions to adult units.

The commission noted a number of areas around the country do not have out-of-hours or weekend cover for children with mental health issues which increases the risk of them being put into adult units.

Commission chairman John Saunders said children have very specific mental health needs which are not provided for in adult units. He said children are often terrified when admitted and this is made worse if they are surrounded by adults who are also suffering major mental health episodes.

State of distress

“The reason why they are being admitted at all is because they’re in a critical state of distress and they’re probably coming from a difficult or unsafe family environment. If you admit them to a unit with twenty adults in similar situations, that’s not appropriate.”

There are more than 2,400 children on the waiting list for CAMHS, 218 of whom have been waiting for more than a year. More than 80 posts across CAMHS teams nationwide remain unfilled.

A HSE spokesman said it is “challenged” in recruiting staff to CAMHS and that “every effort is being made to reopen beds in our dedicated units which are currently closed due to staff shortages”.

Adult involuntarily admissions have also climbed, the report says, reaching 2,414 last year. In 2012, the total was 2,141.

The commission noted major difficulties in recruiting and retaining enough staff to keep beds open across all mental services. Overtime and agency nurses were being used to fill gaps in cover and important psychiatric posts were being filled by locum staff.

Some 94 per cent of approved centres were non-compliant with staffing, “mainly due to staff training”.

The report states that over a quarter of the non-compliance by units was rated as “high or critical risk” last year compared with 18 per cent in 2015.