Listen Up - Social Welfare Portal

listenup!Chapter 1 | 11The importance of psychological wellbeingin children and young people, for their health,emotional, social, physical, cognitive and educationaldevelopment, is well-recognised.DfES, DH, 2004Young people face increased vulnerability in relationto their mental health, particularly during thetransitions of adolescence and into early adulthood,which are unparalleled at any other stage of theirlives. However, for young people with mental healthproblems, this critical period is also the time whenstatutory mental health support becomes less clearcut.Services that have an age-specific, dedicatedservice for young adults are not universally available(Pugh & Meier, 2006) and the only statutory mentalhealth service that must be available to span thisage group is the Early Intervention in PsychosisTeam (DH, 2001). In 2003, the Commission for HealthImprovement reported that at least 26 Trusts in theUK did not have agreed and established writtenarrangements to ensure transition of care forservice users between child and adolescent mentalhealth services (CAMHS) and adult mental healthservices (AMHS) (CHI, 2003). This is reflected in theinconsistencies between different services. Whilstsome end their support when the young personreaches 16 years old others do so at 18 or 19 years old(DH, 2004). In some areas, AMHS can start up to threeyears after CAMHS has withdrawn support, meaningthat vulnerable young people can disappear entirelyfrom statutory services (YoungMinds, 2000). As theage of 16 is also the cut-off age for other statutoryservices such as compulsory education and care, thisgap can easily leave vulnerable young people with asevere lack of adult support in their lives. YoungMindslooking at the 16–25 age range recommend that:“CAMHS [children and adolescent mental healthservice] and AMHS [adult mental health services]commissioners need to unite to support youngpeople and create an integrated system of localplanning that includes the widest possible networksof agencies that work with young people.”YoungMinds, 2006Young people are often inappropriately admittedto adult mental health wards. The Mental HealthAct Commission (MHAC) (England and Wales) haveargued that there should be robust admission criteriafor the admission of a minor to an adult ward, andthat protocols should be in place to ensure thattransfer arrangements are made as soon as a moreappropriate placement in a child or adolescentservice can be located. They also recommended thatpolicies should ensure that every child or adolescentthat is admitted to an adult ward is individually riskassessed, so that ward staff are aware of any risksto the young person from other patients (MHAC,2007). MHAC also explicitly argued that during thistime, children and young people should be keptas fully informed as possible about their care andtreatment, and their views and wishes should betaken in account, while having regard to their ageand understanding.These issues are echoed by the HealthcareCommission and the Children’s Commissioner forEngland, whose recent report reveals that, despitea number of improvements in the last few years,young people with mental health problems arereceiving inappropriate and inadequate care onadult wards because of a continuing shortage ofhospital beds and facilities for under-18-year-olds.Although this report concluded that some youngpeople experienced a good level of care andsupport on adult psychiatric wards, the majority ofyoung people involved in the consultation reportednegative experiences. Many were “…left feelingisolated, bored, uninformed and uninvolved indecisions about their mental health care” (Children’sCommissioner for England, 2007). At the time ofgoing to press, the Mental Health Bill (England andWales) was nearing completion and, in this, is acommitment to ensure age-appropriate inpatientenvironments for children and young people.In Wales, the Healthcare Inspectorate Wales and theWales Audit Office have begun a review of childand adolescent mental health services in responseto concerns over progress on the “development