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Admissions to Acute Medical Wards Due to Mental Health Problems Amongst Children and Young People in England, 2012 to 2022
Background: There are challenges in providing high quality care for Children and Young People (CYP) who are admitted to acute medical wards due to mental health problems. There is concern these admissions are increasing, yet national data describing these patterns are lacking.
Methods: We used data on all admissions to medical wards in England amongst CYP aged 5-18 from April 2012 to March 2022. We classified admissions due to mental health problems using the Global Burden of Disease Study cause hierarchy. We describe national trends in mental health admissions over time by sex, age, ethnicity, index of multiple deprivation (IMD) quintile, and examined geographic variation across Integrated Care Boards (ICB). We examined associations between sociodemographic and clinical factors and odds of the admission lasting more than 1 week, and hazard of repeat admissions, using mixed effects models.
Findings: We identified 342,511 admissions for any cause in CYP aged 5-18 in 2021-22 in England, of which 39,925 (11.7%) were due to mental health problems. 21,337 (53.4%) of mental health admissions were due to self-harm. Between 2012 and 2022, annual mental health admissions increased by 65.0%, compared with a 10.1% increase in all-cause admissions. Increases were particularly steep in females aged 11-15, and eating disorder admissions increased 6-fold since 2012. 7.8% of mental health admissions lasted longer than 1 week, compared with 3.5% of all-cause admissions. 13.4% of CYP were readmitted within 6 months of their first mental health admission. Odds of long stay admission, and hazard being readmitted, were significantly higher for CYP who were aged 11-15, female, from less deprived neighbourhoods, and those with eating disorders.
Interpretation: We found large increases in the number of CYP admitted to acute medical wards due to mental health problems. Further work is needed to understand factors driving these trends, and how to improve care for CYP with mental health problems admitted to medical wards.
Funding: This study is funded by the National Institute for Health and Care Research [NIHR 135036].
Declaration of Interest: None.
Ethical Approval: Ethics approval was provided after review by London Brent NHS Research Ethics Committee on 14th November 2022 (Reference 18/LO/1267).
Keywords: Child and adolescent mental health, psychiatry, eating disorders, general paediatrics
Ward, Joseph L. and Vazquez, Adriana del Pilar Vazquez and Phillips, Kirsty and Settle, Kate and Pilvar, Hanifa and Cornaglia, Francesca and Gibson, Faith and Nicholls, Dasha and Roland, Damian and Mathews, Gabrielle and Roberts, Helen and Viner, Russell and Hudson, Lee D., Admissions to Acute Medical Wards Due to Mental Health Problems Amongst Children and Young People in England, 2012 to 2022. Available at SSRN: https://ssrn.com/abstract=4971458 or http://dx.doi.org/10.2139/ssrn.4971458
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