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Understanding and managing emotional distress on the paediatric ward
  1. Rory Conn
  1. CAMHS, Devon Partnership NHS Trust, Exeter, UK
  1. Correspondence to Dr Rory Conn, CAMHS, Devon Partnership NHS Trust, Exeter, UK; rory.conn{at}

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We are witnessing a concerning increase of young people in mental health crisis, needing paediatric admissions. Vázquez-Vázquez et al’s1 timely and necessary review of the literature focuses on how services can transform to meet the needs of this troubled population. Thirty-two studies are analysed, highlighting rates of admissions, lack of professional preparedness, and the as-yet limited focus on the lived experience of young people and families. The need for better interagency working is emphasised.

What is the problem?

Rates of childhood distress have been increasing for some time, with a significant statistical rise in the prevalence of diagnosable anxiety and depression. Children presenting to hospital are in fact the tip of the iceberg; certainly the most visible, but neither the majority, nor even the most complex of ‘CAMHS (Child and Adolescent Mental Health Services)’ patients, many of whom are suffering in relative silence, in the community.

The Millennium Cohort Study2 reveals that, at aged 17 years, 28% of girls and 20% of boys have self-harmed within the preceeding 12 months. Behind every sad statistic are a series of often preventable psychosocial stressors.

It is crucial to associate but not to conflate self-harm with mental illness. We do not use ‘abdominal pain’ as a diagnosis, rather we seek to understand what is underlying the presenting symptom. I contend that despite the increasing rates of mental illness, the majority of young people admitted to hospital with acts of self-harm have primary social needs. That is not to say that they require safeguarding …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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