RQIA Independent Review of Child and Adolescent Mental Health ...


RQIA Independent Review of Child and Adolescent Mental Health ...

Chapter 7 Young people on adult wards

7.1 Term of Reference 2

Theme 4: Young people on adult wards

Admission to the regional inpatient psychiatric hospital for children and young people has often been limited due to insufficient

number of beds available in Northern Ireland. When a placement is not available in the regional facility and no other service can

be provided a young person aged 16 or 17 may be placed on an adult psychiatric ward. This is an ad hoc process rather than a

care pathway orientated approach. As the care and treatment of young people admitted onto an adult ward is paramount the

DHSSPS issued circulars to trusts outlining what the trusts should include in protocols for the management of young people on

adult wards. Guidelines have also been issued by the Royal College of Psychiatrists and by the Mental Health Commission

(function now transferred to RQIA) in relation to reporting of these admissions. In order to monitor this process RQIA should be

sent notification of each admission to the adult ward and outline how the guidance by the DHSSPS is being met.

During a period of 30 months from April 2007-September 2009 a total of 197 young people were admitted onto an adult ward in

Northern Ireland. Many of these admissions were of short duration and some young people were transferred to the regional

adolescent inpatient unit.

A new purpose built inpatient unit for children and young people, Beechcroft, was opened in May 2010 and the number of beds

available to children and young people has increased from 12 to 18 and from 10 to 15 in the children’s facility. It is unclear what

impact the new regional facility at Beechcroft will have on the number of children admitted to adult wards. At the time of the review

the Belfast Trust was developing admission criteria for the facility.

The review team visited three adult wards in the Belfast Trust, Southern Trust and Northern Trust, where young people have been

placed and interviewed staff who are responsible for the effective care and treatment of the young people in these facilities. Due

to time constraints the review team was unable to view an adult ward in the WHSCT, however was able to speak with members of

the adult ward nursing team. The areas addressed by the review team focused primarily on how safe and developmentally


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