A safety investigation conducted by the Healthcare Safety Investigation Branch (HSIB) has highlighted the significant risk faced by young people with complex mental health needs who are placed in general children’s wards in England. The investigation found that pediatric wards, designed for patients with physical health needs, are not safe or suitable for those with mental health needs. The report described the situation in 18 hospitals as challenging, with 13 of them being deemed unsafe for children at risk of self-harm or suicide. The investigation was prompted by a case where a young patient in a pediatric ward attempted self-harm while awaiting a mental health assessment.
The BBC highlighted the case of a 16-year-old autistic girl who spent several months in a children’s ward, and other families have since come forward with similar stories. Many families faced difficulties in accessing appropriate support for their children with mental health needs. Hospitals have reported an increasing number of children with a combination of autism, learning disabilities, and complex mental health needs.
NHS England acknowledges the need for improvement in mental health services for children and young people. They have ongoing programs to transform these services, including adapting hospital environments to meet the sensory needs of patients. However, the HSIB report raises concerns about the lack of therapeutic help available in pediatric wards and the deterioration of children’s conditions as a result.
The report also highlights the risks of self-harm, including ligature points, in pediatric wards. It mentions the busy and noisy nature of these wards, which can be traumatic for children experiencing mental health crises or those with sensory needs. Security incidents involving high-risk behaviors were frequent, often leading to physical restraint or sedation. Staff expressed concerns about the negative impact on other patients and families, and some hospitals described their workforce as “collapsing.”
NHS England has stated that it will review the concerns raised by the HSIB and incorporate them into ongoing efforts to improve care for children and young people with mental health needs. While it acknowledges that mental health care in acute settings can be appropriate in certain cases, efforts are being made to develop integrated mental and physical health care services through pilot programs and online training platforms for staff.
Miguel Valerio 