A recent study led by experts from the University of Nottingham sheds light on the challenges faced by young individuals in need of urgent mental health care, who find themselves stuck in a hospital limbo. The research, published in BMJ Mental Health, indicates that over 40% of young people endure waits of 7 days or more before being admitted to an adolescent mental health unit, often in acute general hospital settings.
The investigation revealed that many young people, facing acute mental health crises, are placed in general hospital wards, such as pediatric or general medical wards, or even the emergency department, while awaiting admission to an adolescent mental health unit. Disturbingly, more than half of those admitted at a distance were placed in a unit located between 50 and 100 miles from home, with a significant number remaining in the same unit throughout their admission. At a six-month follow-up, 20% were still in hospital.
Dr Josephine Holland, one of the lead authors, expressed concern over the extended wait times for mental health beds, pushing young individuals to wait in settings ill-suited for those experiencing mental health crises. Clinical risk, particularly suicide risk, was a prevalent factor in these admissions, with depression being the most common diagnosis. Over half of the individuals exhibited significant emotional regulation difficulties, and a fifth had a diagnosis of psychosis.
The study, utilizing data from the Royal College of Psychiatrists Child and Adolescent Psychiatry Surveillance System, covered 290 admissions of 13-17-year-olds to general adolescent units far from home or adult psychiatric wards between February 2021 and February 2022. Shockingly, over a fifth of young people waited over 10 days for a bed, while 18% waited for 7-10 days. Only 9% experienced a wait of less than a day.
The majority of these individuals waited in general hospital settings, including pediatric wards (40%), adult medical wards (8%), and the emergency department (7%). Some had to wait in Section 136 suites, specialized holding areas usually located at adult psychiatric hospitals.
Professor Kapil Sayal emphasized the need for service models enhancing mental health crisis care provision in community settings and more intensive therapeutic support for young people waiting in general hospital settings. The study was funded by the NIHR ARC East Midlands, aiming to address health and care priorities by accelerating the adoption of research into frontline practices and promoting evidence-based innovations.
