Abstract
AIMS AND METHODThe lead consultants of all adolescent in-patient psychiatric units in England and Wales were surveyed in 2000 and again in 2005, to determine whether they could admit young people in an emergency.RESULTSIn 2000, 51 of 64, and in 2005, 70 of 79 units responded. Although the number of units with dedicated ‘emergency admission beds’ had increased from 6 to 16, 34% of the total could never admit as an emergency in 2005 and 44% could never admit out of hours. The consultants estimated that, in 2005, they turned away 72% of referrals for emergency admission. Although 87% of consultants agreed that there should be emergency access to specialist adolescent psychiatric beds, concern was expressed that services are not configured to accept emergency admissions.CLINICAL IMPLICATIONSThis problem is unlikely to be resolved by requiring units to accept both emergency and planned admissions. These groups have very different needs. Coherent and unified commissioning is needed to achieve equity of access to emergency beds, along with separate planned admission units and a range of alternative emergency services.
Highlights
87% of consultants agreed that there should be emergency access to specialist adolescent psychiatric beds, concern was expressed that services are not configured to accept emergency admissions
Consistent with this, the lead consultants who responded to the survey estimated that three-quarters of young people referred for urgent admission are turned away
The majority of lead consultants in in-patient adolescent units think that emergency beds are required
Summary
In 2000, 51of 64, and in 2005, 70 of 79 units responded. the number of units with dedicated ‘emergency admission beds’ had increased from 6 to 16, 34% of the total could never admit as an emergency in 2005 and 44% could never admit out of hours. Many clinicians working in community child and adolescent mental health services consider that the ability to admit a young person promptly is the most important attribute of an in-patient adolescent mental health unit (Gowers et al, 1991; Cotgrove, 1997; Corrigall & Mitchell, 2002). This view is echoed by the National Service Framework for Children, Young People and Maternity Services (Department of Health, 2004), which states that ‘there is a particular need to ensure the availability of beds into which emergencies can be admitted’. We discuss the implications of the findings for future planning of services for young people who require emergency admission
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