Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-28T06:06:37.218Z Has data issue: false hasContentIssue false
  • English
  • Français

Non-forensic secure services for adolescents: what are we talking about?

Published online by Cambridge University Press:  21 October 2013

Benjamin Keene ,
Rakendu Suren  and
Rafik Refaat
Benjamin Keene*
Affiliation:
ST6 Specialty Registrar in Child & Adolescent Psychiatry, Department of Child & Adolescent Mental Health, Great Ormond Street Hospital for Children NHS Trust, London
Rakendu Suren
Affiliation:
Locum Consultant Child & Adolescent Psychiatrist, Newham CFCS, East London NHS Foundation Trust, London
Rafik Refaat
Affiliation:
Consultant Child & Adolescent Psychiatrist, Coborn Centre for Adolescent Mental Health, East London NHS Foundation Trust, London E13 8SP & Honorary Senior Lecturer, Barts & The London School of Medicine & Dentistry
*
Correspondence to: Dr Benjamin Keene, Department of Child & Adolescent Mental Health, Great Ormond Street Hospital for Children NHS Trust, London WC1N 3JH. E-mail: benjamin.keene@nhs.net
Get access

Abstract

There is considerable variability in the ethos of the various adolescent in-patient units in Britain. Currently, there are few services within NHS settings able to manage acute behavioural disturbance in adolescents despite the prevalence of psychiatric disorder in this population group. Due to this variation, individual units around the country have developed their own bespoke services for managing disturbance. These services are given different names although may be operating with similar models. However, there is little consensus on these definitions, resulting in services with similar titles providing differing levels of service and varying capacity to manage violence or aggression. We attempt to define patient populations in need of such services and suggest a nomenclature for defining such services that could be universally adopted. We also describe the five-year review of admissions of one adolescent psychiatric intensive care unit and suggest how well its name fits with our proposed model.

Keywords

Adolescentintensive carehigh dependency
Type
Review Article
Information
Journal of Psychiatric Intensive Care , Volume 10 , Issue 1 , April 2014 , pp. 33 - 39
Copyright
Copyright © NAPICU 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Boeing, L., Murray, V., Pelosi, T., McCabe, R., Blackwood, D., Wrate, R. (2007) Adolescent-onset psychosis: prevalence, needs and service provision. British Journal of Psychiatry. 190: 18–26.Google Scholar
Cotgrove, A.J., Gowers, S.G. (1999) Use of an adolescent in-patient unit. Advances in Psychiatric Treatment. 5: 192–199.Google Scholar
Department of Health (1993) The Health of the Nation. Key Area Handbook – Mental Illness. London: HMSO.Google Scholar
Department of Health (2002) Mental Health Policy Implementation Guide: National minimum standards for general adult services in psychiatric intensive care units (PICU) and low secure environments. Department of Health, 64pp. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4010439Google Scholar
Department of Health (2008) Code of Practice: Mental Health Act 1983. London: TSO. http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/Healthcare/Mentalhealth/DH_4132161Google Scholar
Gowers, S., Symington, R., Entwistle, K. (1991) Who needs an adolescent unit?: A referrer satisfaction study. Psychiatric Bulletin. 15: 537–540.Google Scholar
Green, H., McGinnity, A., Meltzer, H., Ford, T., Goodman, R. (2005) Mental Health of Children and Young People in Great Britain, 2004. Office for National Statistics. Palgrave Macmillan. http://www.hscic.gov.uk/pubs/mentalhealth04Google Scholar
Hoare, T., Wilson, J. (2010) Directory of Services for High-risk Young People. London: Centre for Mental Health. http://www.centreformentalhealth.org.uk/pdfs/Centre_for_MH_Directory_of_forensic_camhs.pdf [Accessed 5 November 2012]Google Scholar
Hollis, C. (2003) Developmental precursors of child and adolescent-onset schizophrenia and affective psychoses: diagnostic specificity and continuity with symptom dimensions. British Journal of Psychiatry. 182: 37–44.CrossRefGoogle ScholarPubMed
Jaffa, T. (1995) Adolescent psychiatry services. British Journal of Psychiatry. 166: 306–310.CrossRefGoogle ScholarPubMed
Meltzer, H., Gatward, R., Goodman, H., Ford, T. (2000) The Mental Health of Children and Adolescents in Great Britain. London: The Stationery Office. http://www.ons.gov.uk/ons/rel/psychiatric-morbidity/the-mental-health-of-children-and-adolescents-in-great-britain/1999-survey/mental-health-of-children-and-adolescents-in-great-britain.pdf [Accessed 5 November 2012]Google Scholar
National Institute for Mental Health in England (2009) Legal Aspects of the Care and Treatment of Children and Young People with Mental Disorder: A guide for professionals. London: Department of Health. http://www.nmhdu.org.uk/silo/files/the-legal-aspects-of-the-care-and-treatment-of-children-and-young--people.pdf [Accessed 5 November 2012]Google Scholar
National Mental Health Development Unit (2009) Admission to Hospital and Treatment for Mental Disorder: Children under 16 years old. London: NHMDU. http://www.nmhdu.org.uk/silo/files/admission-to-hospital-and-treatment-for-mental-disorder.pdf [Accessed 5 November 2012]Google Scholar
O'Herlihy, A., Worrall, A., Lelliott, P., Jaffa, T., Hill, P., Banerjee, S. (2003) Distribution and characteristics of in-patient child and adolescent mental health services in England and Wales. British Journal of Psychiatry. 183: 547–551.CrossRefGoogle ScholarPubMed
Parry-Jones, W.L. (1995) The future of adolescent psychiatry. British Journal of Psychiatry. 166: 299–305.Google Scholar
Solomon, J., Thompson, P., Collins, E. (eds) (2011) Quality Network for Inpatient CAMHS: Service standards, 6th edition. London: Royal College of Psychiatrists Centre for Quality Improvement. Available at: http://www.rcpsych.ac.uk/pdf/QNIC_Standards_2011_final.pdf [Accessed 5 November 2012]Google Scholar
Wheatley, M., Waine, J., Spence, K., Hollin, C.R. (2004) Characteristics of 80 adolescents referred for secure inpatient care. Clinical Psychology and Psychotherapy. 11: 83–89.Google Scholar
Zigmond, A. (1995) Special care wards: are they special? Psychiatric Bulletin. 19: 310–312.Google Scholar