Youths in adult units but child beds available

Almost one in five children were admitted to adult psychiatric units last year even though beds were available in the child and adolescent services.

The Mental Health Commission found that 95 (19%) of the 501 child admissions last year were to adult units.

In 75% of admissions of children to an adult unit, there had been unsuccessful attempts to get an inpatient bed in the Child and Adolescent Mental Health Services (CAMHS).

In all cases, the team were told by the various services that there were no available beds at a particular time, or that emergency admissions were not accepted.The commission points out in its latest report that on all the dates that children were admitted to adult centres, there were bed vacancies in one or more of the CAMHS centres — ranging from one to 19.
However, it was unclear why the vacant beds were not made available instead of admitting children to adults units.
It appeared that there were difficulties in getting beds outside of office hours, or that a CAMHS team was not available out of hours.
While parents might be unwilling to admit their child to a CAMHS unit far from home, this was only evident in one admission, according to completed notification forms.
“The practice of admitting children to adult psychiatric units is unacceptable in all but the most urgent of circumstances,” states the report.
It said the lack of access to reported vacant beds in the units suggested improvements were needed in bed management and communications between adult and Child and Adolescent Mental Health Services, as well as a 24-hour emergency service.

Commission chairman John Saunders said they accepted there were very rare occasions where it was necessary for a child to be admitted to an adult unit.

“We need to focus on the issue of providing appropriate responses to children who need very particular and very specific types of intervention,” said Mr Saunders.

Mental Health Reform, the national coalition for mental health, has echoed the commission’s grave concern about community residences for people with a long-term mental illness. In 2014, there were 99 such homes with about 1,300 residents.
However, while the Inspector of Mental Health Services can visit the homes, make findings, and ask the services to provide a quality improvement plan, they are not subject to regulation by the Mental Health Commission.
Last year 20 of the residences were inspected, and only six were found to be in good decorative order, comfortable, and homely.
Some were described as institutional in the report. Inspectors found chairs lined up against the walls in a row, bedrooms devoid of personal possessions, and locked shower facilities.

Commission chief executive Patricia Gilheaney said it was “astonishing” that the number of people now living in unregulated community residences was three times the number of people in the acute mental services.

Ms Gilheaney said it is hoped the Government would introduce legislation later in the year so the commission could use enforcement powers against residences found to have significant shortcomings.

Mental Health Reform director Shari McDaid said it was unacceptable that nearly half of the residences were found to be in poor condition last year.