Significant rise in mental health admissions for young people over last decade

Recently published in The Lancet Child and Adolescent Health journal, the study was led by clinicians at Great Ormond Street Hospital (GOSH) and researchers at University College London Great Ormond Street Institute of Child Health (UCL GOS ICH).

Funded by the National Institute for Health and Care Research (NIHR) and the NIHR Great Ormond Street Hospital Biomedical Research Centre (NIHR GOSH BRC), researchers analysed data on all admissions of five to 18-year-olds to medical wards in England from 1 April 2012 to 31 March 2022.

This study is the first to analyse national trends in mental health admissions of children and young people to acute medical wards.

These dedicated hospital wards are designed to provide rapid assessment, treatment, and care for patients. Acute medical wards serve as a bridge between the emergency department, general practitioners, and other hospital wards, and are separate to specialist mental health wards such as eating disorder units.

Children and young people are most commonly admitted from emergency departments because they are too unwell, or it is not safe for them to go home.

The researchers found that over 10 years, mental health admissions increased from 24,198 to 39,925 (a 65% increase). This was in comparison to just a 10.1% increase in all cause admissions – which rose from 311,067 to 342,511.

Increases in admissions were greatest among girls aged 11 to 15, rising from 9,091 to 19,349 (112.8% increase), and for eating disorders, rising from 478 to 2,938 (514.6% increase).

As the study looked at admissions of up to 18 years of age, the acute medical wards included both children’s wards and adult wards.

“Acute medical wards are important places for caring for young people with mental health concerns – especially those with co-existing physical health problems like starvation from an eating disorder.

“However, the increased intensity we describe is presenting real challenges for acute wards, both for patients and their families and the staff supporting them. They may not be set up with an appropriate ward environment for this care, and sometimes staff working there need more training and support with relevant skills. This calls for better co-working between physical and mental health professionals across hospital and community teams, including, for example, adequate provision of psychiatrists and mental health trained nurses to support physical medical care on the actual ward.”

The researchers were unable to pinpoint the reasons behind the substantial increase in mental health admissions in their study from this national level data. However, they are now collating more detailed data on reasons for admissions from a selection of children’s wards in England, alongside interviewing young people, their families, and staff working on wards.

From this, they hope to better understand the needs and problems for these admissions to guide appropriate and effective interventions and improvements.

Dr Hudson said: “At a bigger level, we are all currently grappling with and trying to figure out why more and more young people are suffering with their mental health but it’s likely the bigger background prevalence of mental health problems, and possibly increased severity of individual cases, leading to increased presentations to hospitals that require an emergency admission to a general ward because it is not safe for the patient to go home.

“Our findings also show that these increases are not solely down to the COVID-19 pandemic, as there have been year on year increases in numbers of admissions since 2012. This is an issue that appears to now be core business for acute wards, and isn’t going to go away, so a focus on improving care is essential. We hope this study and our future work will help with this.

“Beyond that, it is of course crucial to understand the factors driving these presentations to better support the mental health of young patients.

All research at GOSH is supported by the NIHR GOSH Biomedical Research Centre.