Aims Concerns have been raised about a perceived rise in children and young people admitted to paediatric wards with mental health difficulties, and about the support available for them. However, there has been no detailed analysis to date of mental health (MH) related admissions data.
The main aims of this project were to investigate regional MH-related paediatric admissions by:
Describing the prevalence of admissions with an MH code, and the most common codes associated with admissions.
Examining trends in prevalence over time.
Methods We used data from 2006–2017 obtained from six acute trusts in one region as part of an ongoing hospital admissions project. A comprehensive coding list was developed to identify admissions with MH-related codes; subdivided into codes for mental, behavioural and neurodevelopmental disorders and codes for intentional self-harm. For each Trust we calculated the proportion of all admissions that had an MH-related code, identified the most common codes, and examined changes in prevalence of MH-related admissions over time. We also described whether MH-related diagnoses were coded as primary diagnoses.
Results The overall proportion of admissions which were MH-related varied by trust from 0.45% to 7.97%, and the proportion with an intentional self-harm code ranged from 0.30% to 3.41%. In all trusts, less than 1% of admissions had an MH-related code as the primary diagnosis. The proportion of admissions with an MH-related code increased over time, both for mental, behavioural and neurodevelopmental disorders and for intentional self-harm, for all trusts. The most common MH-related codes used as primary diagnoses were acute alcohol intoxication and anorexia nervosa.
Conclusion Our findings suggest there has been a rise in MH-related paediatric admissions over time, and that this rise is not solely due to an increase in self-harm. This has implications for prevention, for planning appropriate care and pathways for those admitted with an MH problem, and for staff training and support. Perhaps most importantly, Trusts that only capture primary diagnosis codes risk underestimating mental health needs in the paediatric population.
Acknowledgement Thanks to National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) South West Peninsula and to the Academy of Medical Sciences INSPIRE programme who funded the lead author for a medical student summer scholarship.
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