The latest official figures show a 65 per cent rise over five years in the number of children aged between 10 and 14 admitted to psychiatric wards. In 1985, 38 of every 100,000 in this age range were admitted; by 1990, the figure had risen to 63, some 1,700 children in all. Over the same period, the number of adults admitted fell by 9 per cent.
The same picture emerges for other young people. The numbers of 15 to 19-year-olds admitted to psychiatric hospitals rose by 21 per cent to 5,900, and of under- 10s by 42 per cent to 1,100. Some children as young as five end up in hospital.
Child psychiatrists blame increasing psychological pressure on children for what they admit is a deeply worrying increase in mental illness. However, they also point to spending cuts that have closed children's homes and special schools, run down child guidance clinics, and reduced money for specialised therapy. They say the cuts result in children with difficult behaviour being 'dumped' in psychiatric wards.
Dr Greg Richardson, consultant in charge of the Lime Tree adolescent psychiatric unit in York, said: 'I have a lot more pressure to admit young people for problems previously dealt with by social services . . . there is a difference between psychiatric illness and disturbance by life's circumstances. If they have not got an illness that is treatable, they do not belong in hospital.'
Another consultant, in charge of a psychiatric unit for children under 12 - who wanted to remain anonymous - said between 60 and 70 per cent of the children in the unit were there for 'conduct disorders' rather than any specific psychiatric illness.
But demands on all child psychiatric services are increasing. Dr Brian Jacobs, consultant psychiatrist at London's Maudsley Hospital, said the numbers referred to child outpatients' departments had risen by more than 30 per cent over the past three years. 'Unemployment and poverty have affected family stability,' he said. 'A lot more families have come under increasing pressure because of economic and social circumstances, and children have suffered.'
There is also concern that the higher admission figures could indicate that more young people are being admitted to adult psychiatric wards. Child and adolescent facilities have been closing rather than expanding. The Department of Health has told health authorities that children and adolescents should only be admitted to adult psychiatric wards in emergencies. But anecdotal evidence suggests teenagers are being admitted to adult wards because not enough beds are available in specialist units or they are too far away.
Children and young people under 18 can be admitted to psychiatric hospitals as 'voluntary' patients without their consent if parents or - if they are in local authority care - social workers agree. Because they do not need to be detained under the Mental Health Act they cannot appeal to a Mental Health Tribununal, as may adults held against their will. Neither do they have the legal rights of children in children's homes to protection from certain sanctions, such as being forced to wear nightwear during the day or being refused certain foods, nor a right to complain formally about their treatment.
Unlike general hospital children's wards, children's psychiatric wards rarely have open visiting arrangements for families. Dr Jacobs said many discourage visiting during the week and send children home at weekends.
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