83 children put in adult psychiatric units last year, despite guidelines
A LARGE number of children ended up being admitted to adult psychiatric units last year, with some spending up to five months in facilities – despite instructions to end the practice.
Dr Susan Finnerty, assistant inspector of mental services, said 83 children were placed in the adult units, some of them more than once.
More than four in 10 of the young patients were just 16 years or less, a new report has revealed.
The Mental Health Commission – the national watchdog for psychiatric services – issued guidelines in 2011 saying that by the end of that year there should be no more admissions of children under 18 to adult units.
Dr Finnerty's report found that one of the problems was a lack of emergency cover in the child and adolescent mental health services over the weekend and this led to young people having to be sent to the adult units on Saturday and Sunday.
Other problems included lack of available or suitable beds in the child centres, as well as staff shortages, which meant beds could not be made operational.
There were 91 admissions of children to adult units in 2013. Five, or 6pc, of those young people were detained involuntarily and in another case, the legal status of the child changed from voluntary to involuntary.
She said six in 10 of the children stayed in the adult unit for periods in excess of three days and 21pc were still there after 10 or more days. Over 6pc were under 16 years of age and just over 37pc were 16 years old.
The reason cited in more than 60pc of the cases was that there were no beds available in the child and adolescent mental health units on the day of admission.
"Yet analysis of the vacancies within the units showed that there were, in fact, vacancies on all but three of these dates – on occasions in excess of 10 beds," she said.
Dr Finnerty said it must be concluded that the admission of children to adult units did not appear to be due to shortage of child and adolescent beds within the in-patient system at the time of admission – despite adult services being informed there were no beds available.
"Factors which may contribute to in-patient units being unable to admit a child, even though there were vacancies, include gender issues in sleeping accommodation, a disturbed child in the unit or families unwilling to have their child admitted to a child and adolescent unit that is some distance from their homes."
She also pointed out the lack of emergency services for children presenting for admission to young people's units and that 23pc of these were on Saturday and Sunday.
Length of stay varied, between discharges on the same day of admission to over 142 days – with 21pc of children staying in an adult unit for more than 10 days.
The number of children admitted to adult in-patient units was evenly distributed across the HSE areas.
According to the HSE Fifth Annual Child and Adolescent Mental Health Report 2012-2013, the number of child and adolescent in-patient HSE beds in 2013 was 60. Not all the 60 HSE child and adolescent beds were operational in 2013.
Eist Linn unit said its capacity of in-patient beds was actually 17 beds, as three beds were designated special care beds and were not included in the bed complement. By the end of the year 48 of the beds were operational.