Mental health admissions of children to acute wards in England have increased by 65% in ten years
The number of children admitted to acute hospital wards in England due to serious concerns about their mental health has risen by 65% in a decade, with a particularly alarming rise in the number of girls who have self-harmed, research shows.
Doctors treat almost 40,000 children with acute mental health problems in general wards every year, compared to around 24,000 a decade ago. The increase is six times higher than the increase in child admissions for all conditions (10.1%) in the same period.
The Guardian previously revealed how a growing number of children were seeking help for mental health problems, including some needing emergency treatment after waiting too long for regular NHS care. The Covid-19 pandemic, social inequality, austerity and internet-related harm are among a range of factors fueling the crisis.
A new study published in the journal The Lancet Child & Adolescent Health sheds light for the first time on how rising numbers are being admitted to acute hospital wards due to clinical concerns about the state of their mental health.
General acute medical units are specialized hospital units designed to quickly assess, treat and care for patients. The units serve as a bridge between emergency departments, GPs and other departments and are separate from specialist mental health units such as eating disorder units.
The study’s senior author, Dr Lee Hudson from UCL, said: “Over the past decade we have seen a significant increase in mental health admissions among children and young people in acute medical wards.
“While there has been a focus on increasing mental health referrals in the community and inpatient mental health settings, admission to general acute medical settings feels like a piece of the puzzle missing from the story.”
Acute units are increasingly playing a critical role in caring for children with coexisting physical and mental health problems, such as starvation from an eating disorder, Hudson said.
“However, the increased intensity we describe poses real challenges for acute units, both for the patients and their families and for the staff who support them. They may not have a suitable ward environment for this care, and sometimes the staff working there need more training and support with relevant skills.”
Hudson and his colleagues found that mental health admissions of five to 18-year-olds to acute wards rose by 65%, from 24,198 in 2012/13 to 39,925 in 2021/2022. According to the analysis, more than half (53.4%) were due to self-harm.
By comparison, there was a 10.1% increase in all-cause admissions over the same period, from 311,067 to 342,511.
Dr. Karen Street of the Royal College of Paediatrics and Child Health said the 65% increase was further evidence of the “alarming deterioration” in the mental health of children and young people.
The rise in mental health admissions was particularly strong among girls aged 11 to 15, with the study also highlighting “steep relative increases” among children aged five to 10 and “striking rates of self-harm among women” .
The number of annual admissions for eating disorders also increased from 478 to 2,938.
after newsletter promotion
Of the 239,541 children and young people admitted for mental health problems between 2012/13 and 2021/22, 13.4% were readmitted within six months.
Hudson and his colleagues are trying to figure out why more and more children are being admitted to acute medical units for mental health reasons, he said.
“But it is likely that the greater background prevalence of mental health problems, and possibly the increased severity of individual cases, is leading to more presentations to hospitals requiring emergency admission to a general ward because it is not safe for the patient to go home. “
The analysis showed that the increases were not solely due to the pandemic, as there had been year-over-year increases in admissions since 2012, Hudson said.
“This is an issue that now appears to be core business for acute departments, and is not going away, so a focus on improving care is essential.”
England’s director of mental health, Claire Murdoch, said the NHS had responded to record numbers seeking help by rolling out hundreds of mental health teams in schools and offering 24/7 crisis support through 111, but sometimes requiring hospitalization in their best interests, so they could receive ‘intense specialist support’ and reduce the risk of harm.