A staggering 65% surge in children and young people admitted to general acute medical wards for mental health concerns has shaken England’s healthcare system over the past decade, according to a groundbreaking study led by UCL researchers. Published in The Lancet Child and Adolescent Health, the study—funded by the National Institute for Health and Care Research (NIHR) and the NIHR Great Ormond Street Hospital Biomedical Research Centre (NIHR GOSH BRC)—unveils a deeply troubling trend. Analyzing nationwide hospital admission data from April 1, 2012, to March 31, 2022, researchers paint a stark picture of the growing mental health crisis among five- to 18-year-olds, signaling an urgent need for systemic change.
General acute medical wards are specialized hospital units that offer rapid assessment, treatment, and care. Acting as a link between the emergency department, general practitioners, and other hospital wards, they differ from specialized mental health units like those for eating disorders. Children and young people are typically admitted to these general wards from the Accident and Emergency department when their condition is too serious, or their home environment is unsafe, for discharge.
The researchers found that over the course of 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 11-15, rising from 9,091 to 19,349 (112.8% increase), and for eating disorders, rising from 478 to 2,938 (514.6% increase).
This study is the first to analyse national trends in mental health admissions of children and young people to acute medical wards. 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.
Senior author, Dr Lee Hudson (UCL Great Ormond Street Institute of Child Health and Great Ormond Street Hospital) said: “Over the past decade, we’ve observed a significant rise in mental health admissions among children and young people to acute medical wards. Although there has been attention paid to increased referrals to community mental health services and inpatient mental health settings, admissions to general acute medical settings feels like a piece of the jigsaw missing in the story.
“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 study’s findings come with certain limitations, including the potential underestimation of mental health admissions due to inconsistencies in diagnostic coding and the lack of data on the level of care provided or the use of the Mental Health Act. Additionally, researchers were unable to distinguish between admissions to pediatric versus adult wards or account for shifting admission criteria during the pandemic, which may have influenced the results.
To bridge these gaps, the ongoing MAPS project is gathering more granular data on hospital admissions across select facilities in England. By conducting in-depth interviews with children, families, and healthcare staff, researchers aim to fill these critical knowledge gaps and deepen our understanding of the challenges faced in mental health care.
