‘Far Away from Home’: adolescent inpatient admissions far from home, out of area or to adult wards: a national surveillance study
Background The increasing prevalence and acuity of mental disorders among children and adolescents have placed pressure on services, including inpatient care, and resulted in young people being admitted at-distance or to adult wards. Little empirical research has investigated such admissions.Objecti...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2023-10-01
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| Series: | BMJ Mental Health |
| Online Access: | https://ebmh.bmj.com/content/26/1/e300843.full |
| _version_ | 1797367825882415104 |
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| author | Tamsin Ford Helen Smith Eleanor Smith Udo Reulbach Fiona McNicholas Anne-Marie Burn Richard Morriss Ian Wong Kapil Sayal Dasha Nicholls Anthony James Adam P Wagner Andrew McWilliams Alka Ahuja Cornelius Ani Aditya Sharma Richard Lynn Bernadka Dubicka Boliang Guo Joanne Doherty Marinos Kyriakopoulos Tamsin Newlove-Delgado Josephine Holland James Roe Morenike Dasilva-Ellimah Saeed Nazir Hani Ayash Priya Hodgins Siona Hurley Adele Warrilow |
| author_facet | Tamsin Ford Helen Smith Eleanor Smith Udo Reulbach Fiona McNicholas Anne-Marie Burn Richard Morriss Ian Wong Kapil Sayal Dasha Nicholls Anthony James Adam P Wagner Andrew McWilliams Alka Ahuja Cornelius Ani Aditya Sharma Richard Lynn Bernadka Dubicka Boliang Guo Joanne Doherty Marinos Kyriakopoulos Tamsin Newlove-Delgado Josephine Holland James Roe Morenike Dasilva-Ellimah Saeed Nazir Hani Ayash Priya Hodgins Siona Hurley Adele Warrilow |
| author_sort | Tamsin Ford |
| collection | DOAJ |
| description | Background The increasing prevalence and acuity of mental disorders among children and adolescents have placed pressure on services, including inpatient care, and resulted in young people being admitted at-distance or to adult wards. Little empirical research has investigated such admissions.Objective To determine the incidence, clinical characteristics and 6-month outcomes of patients aged 13–17 years old admitted at-distance (>50 miles from home or out of region) to general adolescent psychiatric wards or to adult psychiatric wards.Methods Surveillance over 13 months (February 2021–February 2022) using the Child and Adolescent Psychiatry Surveillance System including baseline and 6-month follow-up questionnaires.Findings Data were collected about 290 admissions (follow-up rate 99% (288 of 290); sample were 73% female, mean age 15.8 years). The estimated adjusted yearly incidence of at-distance admission was 13.7–16.9 per 100 000 young people 13–17 years old. 38% were admitted >100 miles from home and 8% >200 miles. The most common diagnoses at referral were depression (34%) and autism spectrum disorder (20%); other common referral concerns included suicide risk (80%), emotional dysregulation (53%) and psychotic symptoms (22%). Over two-fifths (41%) waited ≥1 week for a bed, with 55% waiting in general hospital settings. At 6-month follow-up, 20% were still in hospital, the majority in at-distance placements.Conclusions At-distance and adult ward admissions for patients aged <18 remain an ongoing challenge for healthcare provision and have an impact on acute hospital resource use.Clinical implications Long waits in non-specialist settings increase pressure across the healthcare system, highlighting the need to improve local service provision and commissioning to reflect identified clinical needs. |
| first_indexed | 2024-03-08T17:23:39Z |
| format | Article |
| id | doaj.art-546b59581fa546319f73196b54a91bea |
| institution | Directory Open Access Journal |
| issn | 2755-9734 |
| language | English |
| last_indexed | 2024-03-08T17:23:39Z |
| publishDate | 2023-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Mental Health |
| spelling | doaj.art-546b59581fa546319f73196b54a91bea2024-01-03T03:05:08ZengBMJ Publishing GroupBMJ Mental Health2755-97342023-10-0126110.1136/bmjment-2023-300843‘Far Away from Home’: adolescent inpatient admissions far from home, out of area or to adult wards: a national surveillance studyTamsin Ford0Helen SmithEleanor SmithUdo ReulbachFiona McNicholas1Anne-Marie Burn2Richard Morriss3Ian WongKapil Sayal4Dasha NichollsAnthony James5Adam P Wagner6Andrew McWilliamsAlka AhujaCornelius AniAditya SharmaRichard LynnBernadka Dubicka7Boliang Guo8Joanne DohertyMarinos KyriakopoulosTamsin Newlove-DelgadoJosephine Holland9James Roe10Morenike Dasilva-Ellimah11Saeed Nazir12Hani AyashPriya HodginsSiona HurleyAdele Warrilow4 Department of Psychiatry, University of Cambridge, Cambridge, UK9 Department of Academic Child and Adolescent Psychiatry, University College Dublin, School of Medicine & Medical Science, Dublin, IrelandNational Institute for Health and Care Research Applied Research Collaboration (ARC) East of England, University of Cambridge, Cambridge, UKMental Health and Clinical Neurosciences, Institute of Mental Health, University of Nottingham, Nottingham, UKMental Health and Clinical Neurosciences, Institute of Mental Health, University of Nottingham, Nottingham, UKOxford Health NHS Foundation Trust, Oxford, UKNational Institute for Health and Care Research Applied Research Collaboration (ARC) East of England, University of East Anglia, Norwich, UKDepartment of Child and Adolescent Psychiatry, University of York, York, UKNational Institute for Health and Care Research Applied Research Collaboration (ARC) East Midlands, University of Nottingham, Nottingham, UKMental Health and Clinical Neurosciences, Institute of Mental Health, University of Nottingham, Nottingham, UKNational Institute for Health and Care Research Applied Research Collaboration (ARC) East Midlands, University of Nottingham, Nottingham, UKMental Health and Clinical Neurosciences, Institute of Mental Health, University of Nottingham, Nottingham, UKNottinghamshire Healthcare NHS Foundation Trust, Nottingham, UKBackground The increasing prevalence and acuity of mental disorders among children and adolescents have placed pressure on services, including inpatient care, and resulted in young people being admitted at-distance or to adult wards. Little empirical research has investigated such admissions.Objective To determine the incidence, clinical characteristics and 6-month outcomes of patients aged 13–17 years old admitted at-distance (>50 miles from home or out of region) to general adolescent psychiatric wards or to adult psychiatric wards.Methods Surveillance over 13 months (February 2021–February 2022) using the Child and Adolescent Psychiatry Surveillance System including baseline and 6-month follow-up questionnaires.Findings Data were collected about 290 admissions (follow-up rate 99% (288 of 290); sample were 73% female, mean age 15.8 years). The estimated adjusted yearly incidence of at-distance admission was 13.7–16.9 per 100 000 young people 13–17 years old. 38% were admitted >100 miles from home and 8% >200 miles. The most common diagnoses at referral were depression (34%) and autism spectrum disorder (20%); other common referral concerns included suicide risk (80%), emotional dysregulation (53%) and psychotic symptoms (22%). Over two-fifths (41%) waited ≥1 week for a bed, with 55% waiting in general hospital settings. At 6-month follow-up, 20% were still in hospital, the majority in at-distance placements.Conclusions At-distance and adult ward admissions for patients aged <18 remain an ongoing challenge for healthcare provision and have an impact on acute hospital resource use.Clinical implications Long waits in non-specialist settings increase pressure across the healthcare system, highlighting the need to improve local service provision and commissioning to reflect identified clinical needs.https://ebmh.bmj.com/content/26/1/e300843.full |
| spellingShingle | Tamsin Ford Helen Smith Eleanor Smith Udo Reulbach Fiona McNicholas Anne-Marie Burn Richard Morriss Ian Wong Kapil Sayal Dasha Nicholls Anthony James Adam P Wagner Andrew McWilliams Alka Ahuja Cornelius Ani Aditya Sharma Richard Lynn Bernadka Dubicka Boliang Guo Joanne Doherty Marinos Kyriakopoulos Tamsin Newlove-Delgado Josephine Holland James Roe Morenike Dasilva-Ellimah Saeed Nazir Hani Ayash Priya Hodgins Siona Hurley Adele Warrilow ‘Far Away from Home’: adolescent inpatient admissions far from home, out of area or to adult wards: a national surveillance study BMJ Mental Health |
| title | ‘Far Away from Home’: adolescent inpatient admissions far from home, out of area or to adult wards: a national surveillance study |
| title_full | ‘Far Away from Home’: adolescent inpatient admissions far from home, out of area or to adult wards: a national surveillance study |
| title_fullStr | ‘Far Away from Home’: adolescent inpatient admissions far from home, out of area or to adult wards: a national surveillance study |
| title_full_unstemmed | ‘Far Away from Home’: adolescent inpatient admissions far from home, out of area or to adult wards: a national surveillance study |
| title_short | ‘Far Away from Home’: adolescent inpatient admissions far from home, out of area or to adult wards: a national surveillance study |
| title_sort | far away from home adolescent inpatient admissions far from home out of area or to adult wards a national surveillance study |
| url | https://ebmh.bmj.com/content/26/1/e300843.full |
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