British children are still being treated in adult psychiatric wards

Hundreds of mentally ill children and teenagers are being treated on adult psychiatric wards in defiance of a government promise to halt the practice. A report that lifts the lid on the desperate state of mental health services for young people says that only 15 per cent of health trusts have complied with the Government’s commitment that all young people would be treated in special units, not with adults, by this November.

The findings come from the charity Young Minds and the Children’s Commissioner, Sir Al Aynsley-Green. He has, for the first time, used his powers to force primary care trusts (PCTs) to disclose what is going on in clinics and psychiatric hospitals. The report, entitled Out of the Shadows?, says that mental health services for children and teenagers are so stretched that 72 per cent of inpatient referrals are turned away, forcing young people to travel hundreds of miles from their home or, more commonly, to be sent to adult wards.

No national figures on admissions are collected by the NHS but research by the Royal College of Psychiatrists suggests that about a third of the 3,000 or so children and teenagers admitted for inpatient psychiatric treatment each year end up on adult wards. PCTs were told more than 18 months ago that this must stop. It will become illegal in 2010 for all but the most dire emergencies under the new Mental Health Act.

The Children’s Commissioner has singled out some basic standards that adult wards must meet when young people have to be treated there. These are based on government guidelines and the UN Convention on the Rights of the Child. The standards are to ensure that young people feel safe from other patients, know why they are there, what drugs and other treatment they will receive, can maintain contact with their peers and continue with their education.

However, the report says that about half of all PCTs make no special provisions when children are admitted to adult wards. Fewer than one in four trusts allocates young people a key worker with any training in children’s mental health. The report says that is a serious concern. Less than half comply with guidance that young people must be given information on what medication they receive, for how long they will have it and possible side-effects. Only a third have facilities for education and only a quarter offer any daily activities for young people. This has been identified as a particular problem as it is very harmful to leave children and young people “watching the wall” for hours on end.

Independent advocacy, particularly important to young people who are sectioned under the Mental Health Act, is available in 75 per cent of wards and clinics but only 20 per cent advise patients of the service and only a handful have an advocate who has expertise with children. Professor Aynsley-Green said that while some of the findings were encouraging, some trusts clearly did not believe that young people’s mental health was a priority.

Lois Ward, 20, a representative from Young Minds, who helped to compile the report, said: “The young people entering mental health services have their lives ahead of them and it is essential that the environments in which they are placed are safe, supportive and serve to boost their potential in the future.”

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Australia: Paramedic assaulted after public hospital treatment delay

HOSPITAL overcrowding has been blamed for a patient assaulting a paramedic while waiting to be admitted to the Cairns Base Hospital emergency department. Queensland Ambulance union state organiser Jason Dutton said a frustrated patient kicked and punched a paramedic in the head and back as he waited to be treated by emergency specialists. He said the patient, who had been picked up by paramedics at a nightclub, had been waiting outside the hospital in an ambulance before attacking the officer in the early hours of last Thursday morning. The man was seeking treatment for non-life threatening injuries after being involved in a fight.

Bob Lackey, regional delegate for the Liquor Hospitality Miscellaneous Union, which represents ambulance officers, said hospital staff sent security guards to help ambulance officers restrain the man but it was two and a half hours before the patient was finally admitted to the emergency department. "They've got secure areas inside the hospital where they can put patients like that until they calm down," he said. "As a union, we're pretty disgusted. The man was already aggressive. Waiting to get into the accident and emergency department didn't help."

Mr Dutton said Queensland Health needed to address hospital overcrowding to limit aggression aimed at paramedics. Ambulances are frequently forced to wait outside the busiest hospital emergency departments for hours before they can offload patients - a practice known as ramping. "Our members are in the firing line when it comes to people's frustrations and anger," Mr Dutton said. "A lot of our members have been getting verbal aggression but this is the first time that I've been told, as a direct result of ramping, that an officer has been assaulted. "That's unacceptable."

Mr Roberts said the Queensland Ambulance Service continued to work proactively with Queensland Health to minimise delays in handing over patients to emergency department staff.

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