Mental Health

Child Mental Health Wards in North East England Face Improvement Mandate

Four child mental health wards at Ferndene in Northumberland have been downgraded to a status of 'requires improvement' following a series of inspections by the Care Quality Commission (CQC). The inspections revealed several breaches of care regulations, prompting calls for significant improvements in the quality of mental health services provided in the region.

Inspection Findings and Areas of Concern

The CQC's assessment highlighted several areas of concern within the Ferndene wards, particularly relating to the safe care and treatment of patients. A notable issue was the high use of face-down restraint, a practice that drew criticism for not aligning with existing guidance on mechanical restraint. In response to these findings, the mental health trust has initiated a review of its restraint policy to ensure it complies with current standards.

Additionally, the inspections uncovered that staff members lacked necessary training, which further compromised the quality of care. In particular, training for supporting autistic patients was found to be insufficient, prompting the introduction of mandatory training in this area. Despite these concerns, the CQC noted that staff generally treated patients with kindness and respect, and the service offered activities and educational opportunities to young people.

Rising Demand for Child Mental Health Services

The need for improvement in mental health services coincides with a significant rise in child mental health admissions. A study led by researchers from University College London (UCL), and published in The Lancet Child and Adolescent Health, analyzed data from April 2012 to March 2022. The study found a 65% increase in mental health admissions for children aged 5 to 18, with numbers rising from 24,198 to 39,925 over the ten-year period.

Particularly concerning is the dramatic 112.8% increase in admissions for girls aged 11 to 15, alongside a staggering 514.6% rise in eating disorder admissions, which jumped from 478 to 2,938 cases. The study attributes these rising numbers to a combination of factors, emphasizing that the increase is not solely due to the COVID-19 pandemic.

Challenges and Calls for Improved Services

The rising demand for mental health services has placed additional strain on existing resources, with 13 out of 18 units being deemed 'not safe' due to a lack of resources for therapeutic engagement and challenges related to physical ward space. These issues have also impacted the morale of both patients and staff, further highlighting the urgent need for better integration of services and improved collaboration between health professionals.

The study authors call for better training for staff working in acute wards to ensure they are equipped to manage the complex needs of their patients. Additionally, they emphasize the importance of addressing the difficulties associated with managing sedation in children, which can have repercussions on other patients and staff.

Steps Toward Improvement and Future Research

In response to the CQC's findings and the increased pressure on mental health services, several initiatives have been introduced to drive improvements. A new ligature assessment tool has been implemented to enhance patient safety, and there are ongoing efforts to bolster mandatory training for staff.

Further research is being conducted as part of the Mental Health Act Project Survey (MAPS) to address the limitations identified in the initial study, such as issues with diagnostic coding. These efforts aim to provide a more comprehensive understanding of the challenges faced by child mental health services and to inform future strategies for improvement.

As stakeholders continue to scrutinize the performance of mental health trusts in North East England, the focus remains on ensuring that services meet the necessary quality standards to provide safe and effective care for young people in need.