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Mental Health

Over 100 children admitted to adult mental health units

The practice has been labelled “unsatisfactory” by the Mental Health Commission.

MORE THAN 100 children were admitted to adult mental health units last year, the Mental Health Commission’s annual report has revealed.

The situation has been described as “unsatisfactory” by the chairman John Saunders as it contradicts a recent agreement between the HSE and the Commission which explicitly states “no child under 18 years is to be admitted to an adult unit in an approved centre from 1 December 2011″.

During 2012, 357 children were admitted to approved centres, a figure in line with the previous three years.

The Commission said the addition of three child and adolescent units since 2008 has decreased the number of admissions to adult centres. Despite the six suitable units, the practice of admissions to adult beds continued in 2012.

There were a total of 106 admissions of people under the age of 18 - almost a quarter of all child admissions.

The report said it was “encouraging” that there has been a year-on-year decline but warned that “progress must continue” so that all patients receive treatment in age-appropriate settings.

When a child is admitted to an adult unit, the approved centre is required to inform the Commission of the reason for the admission. In 2012, ‘no age appropriate bed available’ was indicated as a reason for admission in 84 per cent of cases.

Twenty-four young people were discharged from the adult unit once a bed became available in a more suitable centre.

Involuntary Admissions

Of the 357 children treated in mental health units, 15 were subject to District Court orders for involuntary admissions.

Five of the 15 children who were the subject of a Section 25 Order were 15 years of age or under, three were 16 year olds and seven were 17 year olds. In the case of three of the 18 involuntary admissions, the child was initially admitted as a voluntary patient but their legal status changed to involuntary during their admission.

Including adults, there were 2,141 involuntary detentions reported across Ireland in 2012.

Automatic independent assessments and reviews of admissions took place in 1,790 of these cases (the detention orders in the remaining 351 cases were revoked before the hearing). The hearings, led by a three-person tribunal including a lawyer, consultant psychiatrist and one other person, saw eight per cent detention orders revoked.

The Commission noted that there was a “considerable geographic variation” in the level of involuntary admissions, ranging from 32.7 people per 100,000 in the HSE Dublin/Mid-Leinster region, up to 50.82 people per 100,000 in the HSE West region.

A number of deficiencies were highlighted in yesterday’s report, including a delay in filling vacant roles, a “slippage in compliance” and a diminished attempt to provide recovery-oriented services.

Download the full report here>

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Use of seclusion and physical restraint in mental health services ‘unacceptable’

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