Child and Young Person Admissions to a District General Hospital under Joint Camhs (Child and Adolescent Mental Health Services) and Paediatrics from January 2019 - April 2021

ABSTRACT

Aims Background Child and young person (CYP) mental health is a public health priority with 75% of life long mental health problems starting before the age of 25.1 Prevalence of all mental health disorders among children aged 5-15 years is 11.2%.2 Aims * To highlight current in-patient numbers and pathway, from initial presentation to discharge. * Identify any changes that can be made to improve care foryoung people admitted with mental health presentations Methods Patients were identified from daily handover sheets from January 2019 to April 2021. Information on each patient was gathered using electronic patient record. Information gathered included 1. Number of CAMHS inpatients broken down by age, gender and diagnosis. 2. Patient pathway including time spent waiting in A&E 3. Use of Registered mental health nurse (RMN) 4. Treatments provided on ward 5. Daily review by peadiatric and CAMHS team 6. Length of stay 7. Place of discharge Results 231 CYP admitted under CAMHS between January 2019 and April 2021. See figure 1. Of these admissions 86% were female. 27 patients accounted for a fifth of admissions. Average age at admission 14 years (8-16 years). IntentionalOverdose was the most common reason for admission. See figure 2. Due to changes in computer systems, complete information regarding patient stay was available for patients between April 2020 to April 2021. 72% of patients beached four hour ED wait of which 80% due to waiting for RMN to become available. 86% of patients required an RMN. 13% of patients were under section at some point during admission. Fifth of patients were discharged to tier 4 services. Average time from admission to discharge was 10 days. The longest admission was 264 days. 97% of patients had daily paediatric reviews and 80% of patients had a daily CAMHS reviews. 62% of patientsengaged in alternative therapy during their stay. Eg art therapy or youth support worker. Conclusion Admission rates dropped during the first COVID 19 lockdown and rates tend to be lower during summer months. There tends to be increased mental health admission following return to school in September. Eating disorder patients tend to have more prolonged inpatients stay due to waiting for Tier 4 bed availability. Lack of RMNs lead to prolonged wait time in ED prior to admission. A mental health awareness teaching week was delivered to the department to encourage the team to carry out HEADSSS assessment for all young people admitted and tailor services around the YP to help improve care of patients with mental health issues. (Figure Presented).