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The ability of adolescent psychiatric units to accept emergency admissions: changes in England and Wales between 2000 and 2005

Clinical Director and Consultant in Adolescent Psychiatry, Pine Lodge Young People’s Centre, 79 Liverpool Road, Chester CH21AW, email: andy.cotgrove{at}cwpnt.nhs.uk

Rachel McLoughlin

Consultant in Child and Adolescent Psychiatry, Adcote House, Wirral

Anne O’Herlihy

Research Fellow

Paul Lelliott

Director, Royal College of Psychiatrists’ Research and Training Unit, London

Declaration of interest

None.

AIMS AND METHOD

The lead consultants of all adolescent in-patient psychiatric units in England and Wales were surveyed in 2000 and again in 2005, to determine whether they could admit young people in an emergency.

RESULTS

In 2000, 51 of 64, and in 2005, 70 of 79 units responded. Although the number of units with dedicated ‘emergency admission beds’ had increased from 6 to 16, 34% of the total could never admit as an emergency in 2005 and 44% could never admit out of hours. The consultants estimated that, in 2005, they turned away 72% of referrals for emergency admission. Although 87% of consultants agreed that there should be emergency access to specialist adolescent psychiatric beds, concern was expressed that services are not configured to accept emergency admissions.

CLINICAL IMPLICATIONS

This problem is unlikely to be resolved by requiring units to accept both emergency and planned admissions. These groups have very different needs. Coherent and unified commissioning is needed to achieve equity of access to emergency beds, along with separate planned admission units and a range of alternative emergency services.