Advertisement

Irish Journal of Medical Science

, Volume 181, Issue 4, pp 555–560 | Cite as

Who gets admitted? Study of referrals and admissions to an adolescent psychiatry inpatient facility over a 6-month period

  • L. S. Wilson
  • B. D. Kelly
  • S. Morgan
  • M. Harley
  • M. O’Sullivan
Original Article

Abstract

Background

Child and adolescent psychiatry services have historically been neglected in Ireland, in terms of resource provision and research.

Aim

To describe referral and admission patterns to an adolescent inpatient unit in Ireland.

Methods

We studied reasons for referral and admission decisions relating to all adolescents referred to St. Joseph’s Adolescent Inpatient Unit (AIPU), Dublin in the first 6 months following its establishment in 2009.

Results

Forty-one adolescents were referred during the study period; 46 % were admitted. There was no difference between those admitted and not admitted in terms of gender (two-thirds were female), age (mean age 16.2 years), most common reason for referral (depression, in almost one-in-two) and suicidality (present in one-in-two). Amongst those referred, 46 % were resident in the primary catchment area. While a majority of admissions occurred within 5 days of referral (53 %), a significant minority were not admitted until over 20 days after referral (16 %).

Conclusions

The demographic and clinical characteristics of adolescents referred and admitted to St. Joseph’s AIPU are consistent with national and international patterns. At national level, the opening of additional beds for adolescents (such as St. Joseph’s AIPU) has had positive effects on admission patterns; our findings indicate a need to further educate referrers about referral criteria, to optimise benefits derived from these new resources. Future studies could examine the potential roles of intensive support services in the community to further maximise use of scarce resources for this patient group.

Keywords

Child psychiatry Adolescent psychiatry Inpatients Mental disorders diagnosed in childhood Ireland Referral and consultation 

Notes

Conflict of interest

There is no conflict of interest to declare.

References

  1. 1.
    Expert Group on Mental Health Policy (2006) A vision for change: report of the expert group on mental health policy. The Stationery Office, DublinGoogle Scholar
  2. 2.
    Guruswamy S, Kelly BD (2006) A change of vision? Mental health policy. Ir Med J 99:164–166PubMedGoogle Scholar
  3. 3.
    Health Service Executive (2010) Second annual child and adolescent mental health service report: 2009–2010. Health Service Executive, DublinGoogle Scholar
  4. 4.
    Department of Health (2007) Mental Health Act 2007, chap 12. Department of Health, LondonGoogle Scholar
  5. 5.
    Department of Health (2009) Working together to provide age-appropriate environments and services for mental health patients aged under 18: a briefing for commissioners of adult mental health services and child and adolescent mental services. Department of Health, LondonGoogle Scholar
  6. 6.
    Kim-Cohen J, Caspi A, Moffitt TE, Harrington H, Milne JB, Poulton R (2003) Prior juvenile diagnoses in adults with mental disorder: developmental follow-back of a prospective-longitudinal cohort. Arch Gen Psychiatry 60(7):709–717PubMedCrossRefGoogle Scholar
  7. 7.
    Healy E, Fitzgerald M (2000) A 16-year follow-up of a child inpatient population. Eur Child Adolesc Psychiatry 9:46–53PubMedCrossRefGoogle Scholar
  8. 8.
    Tulloch S, Lelliott P, Bannister D et al (2008) Costs, outcomes and satisfaction for in-patient child and adolescent psychiatric services (COSI-CAPS). Royal College of Psychiatrists’ Research and Training Unit, LondonGoogle Scholar
  9. 9.
    O’Herlihy A, Worrall A, Banerjee S et al (2001) National In-patient Child and Adolescent Psychiatry Study (NICAPS). Royal College of Psychiatrists, LondonGoogle Scholar
  10. 10.
    Steinberg D, Galhenge DPC, Robinson SC (1981) Two years’ referrals to a regional adolescent unit: some implications for psychiatric services. Soc Sci Med E 15:113–122PubMedGoogle Scholar
  11. 11.
    Ainsworth P (1984) The first 100 admissions to a regional general purpose adolescent unit. J Adolesc 7:337–348PubMedCrossRefGoogle Scholar
  12. 12.
    Pyne N, Morrison R, Ainsworth P (1985) A follow-up study of the first 70 admissions to a general purpose adolescent unit. J Adolesc 8:333–345PubMedCrossRefGoogle Scholar
  13. 13.
    First MB, Spitzer RL, Gibbon M, Williams JBW (2002) Structured clinical interview for DSM-IV-TR axis I disorders, research version, patient edition (ECID-I/P). Biometrics Research, New York Sate Psychiatric Institute, New YorkGoogle Scholar
  14. 14.
    World Medical Association (2008) WMA declaration of Helsinki—ethical principles for medical research involving human subjects. World Medical Association, Ferney-VoltaireGoogle Scholar
  15. 15.
    Data Protection Commissioner (2007) Data protection guidelines on research in the health sector. Data Protection Commissioner, DublinGoogle Scholar
  16. 16.
    O’Herlihy A, Lelliott P, Cotgrove A et al (2008) The care paths of young people referred but not admitted to inpatient child and adolescent mental health services. Royal College of Psychiatrists’ Research and Training Unit, LondonGoogle Scholar

Copyright information

© Royal Academy of Medicine in Ireland 2012

Authors and Affiliations

  • L. S. Wilson
    • 1
  • B. D. Kelly
    • 1
  • S. Morgan
    • 2
  • M. Harley
    • 3
  • M. O’Sullivan
    • 4
  1. 1.Department of Adult Psychiatry, Mater Misericordiae University HospitalUniversity College DublinDublin 7Ireland
  2. 2.Lucena ClinicDublin 6Ireland
  3. 3.St. Joseph’s Adolescent Inpatient Unit, St. Vincent’s HospitalDublin 3Ireland
  4. 4.Mater Child and Adolescent Mental Health Services, Metropolitan BuildingDublin 1Ireland

Personalised recommendations