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Too many children in England’s mental health hospitals unnecessarily – report Too many children in England’s mental health hospitals unnecessarily – report
(about 8 hours later)
Too many children are admitted to mental health hospitals unnecessarily and spending years in institutions, according to a report. Vulnerable children with learning disabilities are stuck in mental health hospitals for long periods and in poor conditions, the Children’s Commissioner for England has warned.
The Children’s Commissioner for England is concerned that the current system of support for those with learning disability or autism is letting children down. A report published on Monday said children were spending months and years unnecessarily in institutions that are often far from their homes, while some were routinely restrained or sedated.
Anne Longfield’s report, which includes “shocking evidence of poor and restrictive practices”, heard from children about how traumatic a stay in a mental health hospital can be. The number is also rising, with 250 children with a learning disability and/or autism recorded as being in a mental health hospital in England in February 2019, compared with 110 in March 2015.
The report concludes: “This research has shown that too many children are admitted to hospital unnecessarily and spending months and years of their childhood in institutions when they do not need to be there.” Anne Longfield, the commissioner, said: “For many of them this is a frightening and overwhelming experience. For many of their families it is a nightmare.
The report said: “It is particularly concerning that this report comes at the end of the Government’s Transforming Care programme but that there has been so little change. “The onus is now on ministers, the NHS, the CQC, Ofsted and local authorities to make sure that these most vulnerable of children are not locked out of sight for years on end simply because the system is not designed to meet their needs.”
“Despite report after report and successive government programmes to address this problem, the number of children in hospital remains unacceptably high.” NHS figures showed that on average, children with autism and/or a learning disability had spent six months living in their current hospital, and eight months in inpatient care in total.
It adds: “From this research, speaking to children and their families and experts who have been working in this field, the clear message was the need to focus on children’s journeys before they are admitted into inpatient care. Although they could have returned home if support had been available, about one in seven children had spent at least a year in their current hospital spell.
“Children, families and staff working in this area spoke again and again about the failure to provide appropriate support to children when they are in school and living the community, and particularly when they reach a crisis point has contributed to inappropriate hospital admissions and delayed discharges.”
The report said 250 children with a learning disability or autism were identified in a mental health hospital in England in February 2019, compared with 110 in March 2015.
According to the report, NHS England state that the figure of 110 was due to under-identification of these children in the past and that the true figure for children with autism and learning disability in inpatient care in 2017 was 260.
“Even with the adjusted figures, the number of children in hospital has not reduced. It is very concerning that the NHS has failed to record accurately the number of children in long term inpatient care, their conditions and their outcomes,” the report said.
Longfield said: “There are around 250 children with a learning disability and/or autism in England living in children’s mental health wards. They are some of the most vulnerable children of all, with very complex needs, growing up in institutions usually far away from their family home.
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“For many of them this is a frightening and overwhelming experience. For many of their families it is a nightmare. I will never forget the stories I heard from mums and dads at a meeting I arranged for parents with children in these units and their tears of frustration and anger. A mother of a teenage girl in hospital told the commissioner’s office: “She’s been in for two years and she’s got to stay there until they find her a place.
“Some of them have a child who has been locked away in a series of rooms for months. Others have to listen as they are told by institutions that their child has had to be restrained or forcibly injected with sedatives. They feel powerless and, frankly, at their wits’ end as to what to do. “She doesn’t need to be in the hospital any more but she’s not allowed to come home. We would like her to be somewhere close to home that we can see her whenever we want and that she’ll be safe, where no one can take advantage of her.”
“A national strategy is needed to address the values and culture of the wider system across the NHS, education and local government so that a failure to provide earlier help is unacceptable, and admission to hospital or a residential special school is no longer seen as almost inevitable for some children. Data provided to the commissioner’s office revealed that 95 children were staying in a ward more than 31 miles from home, while nearly a third of children were in a ward more than 62 miles away from home.
Longfield’s report found that 75 children with a learning disability and/or autism were recorded as having been restrained a total of 820 times in December 2018.
One girl told the Children’s Commissioner’s Office: “I don’t like when they restrain me in my room … when there’s more than two people in my room … I get restrained with an arm around my back … It strained my wrist and it felt numb and had lumps.”
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“There has been report after report and promise after promise to address this issue and yet the number of children in hospital remains stubbornly high.” Physical restraint was the most common type, accounting for three in five interventions, while there was some evidence from children that seclusion had been used not as a last resort but as a threat.
The report, called Far less than they deserve: children with learning disabilities or autism living in mental health hospitals, is published on Monday. The report also highlighted the varied quality of care in hospitals, with one family saying that their son had not been washed for six months while in hospital.
It also noted that children’s care was not being regularly reviewed, with one in four children not appearing to have had a formal review of their care plan within the last 26 weeks, according to NHS data.
ChildrenChildren
AutismAutism
Learning disabilityLearning disability
NHSNHS
Mental healthMental health
HealthHealth
DisabilityDisability
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