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Too many children in England’s mental health hospitals unnecessarily – report

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NHS system for children with learning disability or autism is letting them down, says commissioner

Mon 20 May 2019

Too many children are admitted to mental health hospitals unnecessarily and spending years in institutions, according to a report.

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.

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 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.”

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.

“Despite report after report and successive government programmes to address this problem, the number of children in hospital remains unacceptably high.”

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.

“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.

“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.

“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.

“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.

“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.”

The report, called Far less than they deserve: children with learning disabilities or autism living in mental health hospitals, is published on Monday.


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