The number of children admitted to acute hospital wards in England due to serious mental health problems has increased by 65% in a decade, with a particularly alarming rise in the number of girls who self-harm, research reveals.
Doctors treat almost 40,000 children with acute mental health problems on general wards each year, compared to around 24,000 a decade ago. This increase is six times higher than that of admissions of children for all pathologies combined (10.1%) over the same period.
The Guardian previously revealed how a growing number of children were seeking help for mental health problemsincluding some who need emergency treatment because they had to wait too long for regular NHS care. The Covid-19 pandemic, social inequality, austerity and internet-related harm are among the many factors fueling the crisis.
A new study published in The Lancet Child & Adolescent Health journal highlights for the first time how an increasing number of people are being admitted to acute hospital wards due to clinical concerns about the state of their mental health.
Acute general medicine services are specialist hospital services designed to provide rapid assessment, treatment and care to patients. The units act as a bridge between emergency services, GPs and other services and are separate from specialist mental health services such as eating disorder units.
Lead author of the study, Dr Lee Hudson from UCL, said: “Over the last decade we have seen a significant increase in mental health admissions among children and young people in acute medicine services.
“While much attention has been paid to increasing referrals to community mental health services and inpatient mental health settings, admissions to acute general practice settings appear to be a missing piece of the puzzle in history. »
Acute care services increasingly play a particularly vital role in caring for children with coexisting physical and mental health conditions, such as starvation due to an eating disorder, Hudson said.
“However, the increased intensity we describe presents real challenges for acute care services, both for patients and their families and for the staff who support them. They may not have a suitable service environment for this care, and sometimes the staff working there need more training and support to learn the relevant skills.
Hudson and colleagues found that mental health admissions of adolescents aged five to 18 to acute care services increased by 65%, from 24,198 in 2012-13 to 39,925 in 2021-22. More than half (53.4%) were due to self-harm, the analysis found.
For comparison, all-cause admissions increased by 10.1% over the same period, from 311,067 to 342,511.
Dr Karen Street from the Royal College of Paediatrics and Child Health said the 65% increase provided further evidence of the “alarming deterioration” in the mental health of children and young people.
The increase in mental health admissions was particularly strong among girls aged 11 to 15, with the study also highlighting “large relative increases” among children aged five to 10 and “rates striking rates of self-harm among women.
There was also an increase in annual admissions for eating disorders, from 478 to 2,938.
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Of the 239,541 children and young people admitted for mental health problems between 2012/13 and 2021/22, 13.4% were admitted again within six months.
Hudson and his colleagues are trying to understand why more and more children are being admitted to acute medical wards for mental health reasons, he said.
“But it is likely the greater background prevalence of mental health problems, and possibly the increased severity of individual cases, that is leading to an increase in presentations to hospitals that require emergency admission to a common ward because ‘it is not safe for the patient to return home.’
Analysis showed that the increases were not solely due to the pandemic, as the number of admissions had increased year over year since 2012, Hudson said.
“This is a problem that now appears to be the core business of acute care services and is not going away. It is therefore essential to focus on improving care. »
England’s director of mental health, Claire Murdoch, said NHS had responded to record numbers of requests for help by deploying hundreds of mental health teams to schools and offering 24/7 crisis support via 111, but sometimes admission to hospital was in their best interest so they could get “intense specialist support” and reduce costs. risk of harm.