The number of children being admitted to acute hospital wards due to concerns over their mental health has increased by almost two-thirds in a decade, according to a study.
The rise was particularly high in girls aged 11 to 15, with the analysis also highlighting “steep relative increases” among children aged five to 10 and “striking rates of self-harm in females”.
Researchers warned the issue “isn’t going to go away”, and suggested a focus on “improving care is essential”.
Experts also highlight that while the Covid-19 pandemic had a “profound impact” on youngsters, it is not the “sole factor” in the increase in admissions.
The study, led by a team from UCL, analysed data on all admissions for five to 18-year-olds to general acute medical wards in England from 2012 to 2022.
These wards assess and treat patients and are separate from specialist mental health wards. People are usually referred to a general acute medical ward from the emergency department, or by their GP or outpatient clinic.
In 2021/22, some 342,511 patients aged five to 18 were admitted to hospital for any cause, with 39,925 of these due to mental health concerns.
More than half (53.4%) were due to self-harm, according to the analysis.
Although there has been attention paid to increased referrals to community mental health services and inpatient mental health settings, admissions to general acute medical settings feels like a piece of the jigsaw missing in the story
Researchers found that between 2012 and 2022, annual admissions for mental health concerns increased by 65%, from 24,198 to 39,925.
Dr Lee Hudson, of UCL Great Ormond Street Institute of Child Health and Great Ormond Street Hospital, said: “Over the past decade, we’ve observed a significant rise in mental health admissions among children and young people to acute medical wards.
“Although there has been attention paid to increased referrals to community mental health services and inpatient mental health settings, admissions to general acute medical settings feels like a piece of the jigsaw missing in the story.”
The rise in admissions was “particularly steep” in girls aged 11 to 15, researchers said, climbing from 9,901 to 19,349, an increase of 112.8%.
The team also pointed to “steep relative increases” in admissions for children aged five to 10, with “striking rates of self-harm in females”.
They added: “Although absolute numbers were still low, this finding highlights the burden of mental health concerns in children in this prepubertal age group.”
There was also a hike in admissions for eating disorders, which jumped from 478 to 2,938.
Of the 239,541 children and young people who were admitted for mental health concerns between 2012 and 2022, some 13.4% were admitted again within six months.
Dr Hudson warned the “increased intensity” in admissions is leading to challenges for patients and staff on acute wards.
“Acute medical wards are important places for caring for young people with mental health concerns – especially those with co-existing physical health problems like starvation from an eating disorder,” he said.
“However, the increased intensity we describe is presenting real challenges for acute wards, both for patients and their families and the staff supporting them.
“They may not be set up with an appropriate ward environment for this care, and sometimes staff working there need more training and support with relevant skills.
“This calls for better co-working between physical and mental health professionals across hospital and community teams, including, for example, adequate provision of psychiatrists and mental health trained nurses to support physical medical care on the actual ward.”
More must be done to find out and understand the core drivers for this unparalleled increase to truly design a service which works for our young people
Researchers said the findings, published in the Lancet Child and Adolescent Health, show the pandemic was not solely responsible for the figures.
Dr Hudson added: “At a bigger level, we are all currently grappling with and trying to figure out why more and more young people are suffering with their mental health, but it’s likely the bigger background prevalence of mental health problems, and possibly increased severity of individual cases, leading to increased presentations to hospitals that require an emergency admission to a general ward because it is not safe for the patient to go home.
“Our findings also show that these increases are not solely down to the Covid-19 pandemic, as there have been year-on-year increases in numbers of admissions since 2012.
“This is an issue that appears to now be core business for acute wards, and isn’t going to go away, so a focus on improving care is essential.”
Reacting to the study, Dr Karen Street, officer for mental health at the Royal College of Paediatrics and Child Health, said: “A 65% increase in mental health admissions further evidences the alarming deterioration in the mental health and wellbeing of our children and young people.”
She also called for more to be done to understand what is causing the increase in mental health admissions.
“We know that the pandemic had a profound impact on children and young people,” Dr Street added.
“Yet, rates of worsening mental health among this cohort were also reported in 2012, indicating that Covid-19 is not the sole factor.
“More must be done to find out and understand the core drivers for this unparalleled increase to truly design a service which works for our young people.”
Claire Murdoch, NHS England’s national mental health director, said: “Over the last decade, treatment and awareness of mental health conditions has vastly improved but that also means the health service is treating record numbers as well as dealing with new issues like the negative impact and pressures that social media has on body image for young people.
“The NHS has responded by rolling out hundreds of mental health teams in schools and setting up 24/7 crisis support via 111 for all ages so that people can get easy access to support, but sometimes an admission to hospital is in the person’s best interest so that they can get intense specialist support and reduce the risk of harm.”
