Regional Adolescent Unit Research Articles

Observing nurse-patient interaction.

This article describes an observational study of nurses' interactions with mentally ill young people in a regional adolescent unit. Nurses initiated more than twice as many interactions as patients and were consistent in the average length of time they interacted with the young people. The author recommends that future studies include more qualitative data on the nature of interactions.

Emergency admissions to a regional adolescent unit: piloting a new service

Adolescent in-patient units within the NHS generally provide a broad range of services to large catchment areas and populations. ‘Pine Lodge’ Young People's Centre in Chester has piloted a new emergency admission service which it has run in conjunction with its existing treatment service. This paper sets out to discuss the potential difficulties in providing such a service in the setting of a general purpose adolescent unit; describe the specification of the piloted emergency service; and present the results of monitoring its use and efficacy during the first six months.

Use of mental health legislation in a regional adolescent unit

The use of mental health legislation in a Regional Adolescent Unit over a 10 year period was reviewed. There was a trend of increasing use over time. This was thought to reflect changes in attitude and professional practice subsequent to the introduction of the Children Act 1989. Conversion rates of Section 5(2) were high and practitioners with appropriate training were involved in the majority of sections, indicating good practice.

Neuroleptic prescribing in an adolescent psychiatric in-patient unit

The Royal College of Psychiatrists' consensus statement suggests that prescribing high dose antipsychotic medication in children and adolescents should rarely be necessary. Our objective was to study the prescribing of antipsychotic medication in a regional adolescent unit during a three-year period. We found that antipsychotic prescribing on this unit is common in psychotic disorders and often high closes are required. This is not in keeping with the recommendations of the consensus statement. Review of clinical practice on other adolescent units is needed, together with a more comprehensive evaluation of the outcome of psychotic disorders in this age group.

Patients transferred from a regional adolescent unit to adult wards within the same hospital

In 1986 the report Bridges over Troubled Waters (NHS Health Advisory Service, 1986) stated quite categorically that patients under the age of 16 should not be treated in adult psychiatric wards. The National Association for Children in Hospital has also worked tirelessly against children and adolescents being treated in adult hospital wards, although this has mainly concerned the paediatric, medical and surgical fields. However few guidelines were laid down about the function of psychiatric units for children and adolescents when the majority of such units were first being established in the late 1960s and early 1970s. Indeed in the circular from the Ministry of Health (1964) about the need for such units it was stated that some adolescent patients could suitably be treated in adult wards. However no age limits were specified in the circular. There have been no specific guidelines issued subsequently by the Department of Health about the use of adult psychiatric beds for adolescents.

In-patient treatment of 165 adolescents with emotional and conduct disorders. A study of outcome.

A two-year follow-up study of 165 teenagers with conduct and emotional disorders treated as in-patients on a regional adolescent unit (YPU) is described. The target types of behaviour for each subject were scored independently by the teenager, the parent or guardian, and the professional referrer before admission and at one month, one year and two years after discharge. The significant overall improvement in behaviour observed at one month after discharge was sustained at one and two years. Thirty-three subjects who abandoned treatment within six weeks of admission had made significantly less progress than the fully treated group at one month after discharge, but there were no significant differences at the one- and two-year evaluations. Two years after treatment, between 69% and 79% of the 132 subjects who completed treatment were regarded as improved, depending on which respondent made the assessment. Adolescents who completed treatment had different characteristics from those who terminated treatment prematurely and were more likely to be girls in care referred by social services.

Method in our madness? An audit of a regional adolescent unit

Adolescent psychiatric services differ considerably in terms of the patient groups they seek to address and in their modes of treatment (Health Advisory Service, 1986). The Prestwich Adolescent Unit is a general purpose, seven day, regional service for adolescent psychiatry, based in Salford Health Authority. Serving a population of 4½ million, it offers a mix of in-patient, day-patient, out-patient and consultation/liaison work, specialising in the treatment of mental illness.

Adolescents with obsessive-compulsive disorder: a case note review of consecutive patients referred to a provincial regional adolescent psychiatry unit

A number of clinical descriptions of Obsessive-Compulsive Disorder (OCD) in adolescence are available but are often of small numbers of cases with highly selective recruitment methods. We describe the findings of a systematic case note review of 44 consecutive OCD patients referred to Oxford Regional Adolescent Unit between 1974 and 1984. The relative frequencies of previously described features of the condition in this age group are presented. Many patients had problems with peer relationships and social isolation, which often preceded the onset of other symptoms by many years. The management of the cases and outcome at discharge are outlined.

Reasons for admission to an adolescent unit

Three years admissions to a regional adolescent unit are analyzed to obtain information on the referral, the adolescent and family, and the behaviours leading to admission. The findings are discussed with particular relevance to the N.H.S. Health Advisory Service report on services for disturbed adolescents. Possible implications of the report which are not described by the H.A.S. are described.

Two years' referrals to a regional adolescent unit: Some implications for psychiatric services

During a two year period the problems presented by 500 boys and girls referred to a psychiatric service for adolescents were examined. Their problems were multiple and complicated, and the contribution that could be made by a primarily psychiatric team varied considerably and in some cases was minimal. There was a tendency for the most urgent, pressing requests for admission to be on behalf of young people in long standing social difficulties for whom immediate admission to a psychiatric unit was least appropriate. It was concluded that while there is undoubtedly a core of adolescents with complex personal problems who are best helped in a psychiatric unit, this group is of uncertain size and perhaps smaller than is sometimes thought. What was in less doubt was our impression that for a substantial number of those referred for admission, alternatives to psychiatric care were more appropriate and would be available if non-clinical resources were more effectively organised, staffed and supported. Implications for the development of services for adolescents are discussed.

A training scheme for child psychiatrists.

In 1968 a new regional child psychiatry unit was opened in Birmingham, followed in 1969 by a regional adolescent unit. These events coincided with a general recognition of the need to train more child psychiatrists. It thus became possible to plan a new training scheme, using the new units, without the constraints which might have resulted from the existence of an established pattern of postgraduate training.