A death of reason
Authors: D. Spence
Journal: BMJ (2010)

<h3>Aims</h3> Is there a new epidemic ongoing of mental health disorders in children and young people (CYP)? Comparing mid pandemic March 2021 to pre-pandemic 2017, the rates of probable mental disorders have increased from 1 in 9 for 6 to 16 years-olds and 1 in 10 for 7 to 19 year-olds to 1 in 6, for both age populations.<sup>1</sup> From a recent survey of paediatricians across the UK, 89% report an increase in admissions of CYP with primary mental health diagnoses to acute paediatric units.<sup>2</sup> This was a comparison of the first quarter of 2021 to the first quarter of 2020.<sup>2</sup> Many of the anonymous responses felt that the access to inpatient mental health services and support was poor.<sup>2</sup> They also reported a lack of skills and training in regards to mental health presentations,<sup>2</sup> however CYP have always been admitted to acute paediatric units, for example 6% of acute beds across the UK in 2019 (pre-pandemic) were occupied by CYP with a mental health disorder.<sup>3</sup> This review will be of all mental health disorder presentations to an Emergency Department and admissions to acute paediatric wards at a children’s hospital; assessing the frequency of admissions, source of referrals, length of admission, time to initial CAMHS assessment, frequency of CAMHS interventions during admission and final discharge destination. This review will also take into consideration repeat presentations and will be inclusive of all presentations of under 18’s, even if those who are over 16 years old choose to present to the adult emergency department. <h3>Methods</h3> Database formation of each presentation and admission during 2021 using data collected from Emergency Department Software and ward-admission database and then audit of each objective data point. Responses from an anonymous survey of staff across the children’s hospital will be reviewed to identify common responses and reflections of training, experience, and thoughts on the current CAMHS service provided. <h3>Results</h3> Data processing is currently ongoing, however over 800 presentations of CYP to the Emergency Department have been identified across 2021. All acute paediatricians and senior nursing staff an anonymous survey. Other allied health professionals that participate in care of CYP with mental health disorders will also be included. <h3>Conclusion</h3> This review will provide a snapshot of CYP with mental health disorders presenting to a children’s hospital and their admissions within an acute paediatric service. It will also highlight common themes from the survey, identifying key ideas to better the future management of this ever-growing population of CYP. <h3>References</h3> Mental Health of Children and Young People in England 2021 – wave 2 follow up to the 2017 survey, NHS Digital. Increased admissions to paediatric wards with a primary mental health diagnosis: results of a survey of a network of eating disorder paediatricians in England, <b>Hudson LD</b>, Chapman S, Street KN, Nicholls D, Roland D, Dubicka B, Gibson F, Mathews G, Viner RM. A snapshot of general paediatric services and workforce in the UK, Royal College of Paediatrics and Child Health.