Institutional blind spot around mental health needs of paediatric patients

“In brief” cites the new Care Quality Commission (CQC) survey of children in hospital: “87% rated their overall experience as seven or above out of 10.”1 This gives a false impression. I hope a more detailed report from The BMJ will follow. In its report, the CQC states “Less than half (49% of parents and carers of children with a physical disability, and 48% of those with children with mental health needs or a learning disability) felt that staff definitely knew how to care for their child’s individual needs. This compares to 72% of parents and carers of children without these conditions.”

Professor Edward Baker, CQC’s deputy chief inspector of hospitals comments: “What is particularly worrying is that children with physical, learning or mental health needs are telling us they have poorer experiences. This needs to be addressed straight away so that services meet the needs of all children, irrespective of any disability or specific need.”2

Despite a series of national guidelines over the years,3 there has been a consistent blind spot around the mental health needs of children in hospital.4

There are good reasons for this. Most paediatricians have not been well served by mental health and psychology so lack the knowledge with which to campaign for better resources. The most recent national review on child and adolescent mental health services, although aware of the need, failed to highlight mental health liaison as a right of all children in paediatric care.5 The BMJ could help by casting an authoritative light on a neglected but vital element of child health.