Increasing Treatment of Under 18s in Adult Mental Health Units Unacceptable

Around one in ten children and adolescents are affected by mental health problems and while the majority of young people receive treatment in the community, when the situation escalates admission to a ward may be necessary. Specialist inpatient facilities are available for children, but it was previously noted that some children receive care in inappropriate facilities designed for adults.


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However, despite the Department of Health’s promise that treatment of the under 18s on adult mental health units would not take place after 2010, Freedom of Information data shows the number of young people with mental health issues treated under these circumstances is on the increase.

Under 18's treated on adult wards
Under 18’s treated on adult wards

More young people treated in adult units
Data from 51 mental health services across England showed that for 2013-2014, 350 young people aged 17 years or under had been admitted; this compares to 242 in the two years prior to this. These figures included 12 children under 16 years of age, one as young as 12, in comparison to just 3 under 16s from the previous data. As a result of these findings, Dr Jacqueline Cornish, who is NHS England’s Clinical Director for children and young people, has promised an urgent review of service provision.

Treatment far from home
Treatment on adult wards isn’t the only issue raised by the figures, as 10 of the mental health trusts placed children in facilities further than 150 miles from their home; the worst case involved a 275 mile placement, where a child from Sussex was treated in Greater Manchester. Sometimes these distant placements are to ensure that children receive the best possible care for their condition, with doctors making tens of phone calls every day to ensure the most appropriate care. However, as child psychiatrists point out, when placed in care far from home, it is more difficult for family and friends to keep in touch, which limits the social support available, something they vitally need.

When far from home, this leaves children feeling isolated, unsettled and distressed, which can adversely affect their well-being and hamper their recovery; in some cases it may be enough for them to reach crisis point. With funding cuts for child and adolescent mental health services in the community though, it is harder for young people to receive outpatient treatment, which puts increased pressure on the bed shortage in inpatient mental health units. Children admitted to adult mental health facilities are additionally sometimes exposed to disturbing conditions on these wards and their experience may leave them less willing to engage with future mental health interventions.

Need for specialist care
The under 18s age group need treatment for mental health conditions in a suitable environment, which is appropriate for their age and needs, so treatment on adult units is nearly always unacceptable. A Department of Health spokesman advised that £54million was invested to enhance the services offered, including better access to talking therapies geared towards young people. These early interventions are vital to reduce the risk of children’s mental health problems increasing to the level where they require hospital admission, but there remains a lack of early help. This explains why the Department of Health has been unable to deliver on its previous promises to make mental health services for young people a priority.

Children and adolescents require timely, quality treatment in an appropriate environment, which will require further investment in specialist inpatient facilities for young people. Further research is also needed into the mental health requirement of under 18s in the UK to ensure that service commissioning is based on up-to-date information to provide the most suitable interventions and services for them.