The Mental Health Act Commission (MHAC) has voiced concerns about the treatment of children and adolescents under the Mental Health Act within adult mental health facilities in each of its past four Biennial Reports. A survey of all relevant providers during the period 1999-2001 found that 62 per cent of all children and young people under 18 admitted to inpatient care under the Act were placed on adult wards. In April 2002 the MHAC introduced a requirement for all mental healthcare providers to notify the Commission every time a young person under 18 years of age was formally admitted under the Mental Health Act 1983 and placed on an adult ward. During the 18-month period between April 2002 and September 2003 the Commission received 270 notifications, most for persons aged 16-17. Two-thirds of patients were male. There was a very significant over-representation of young people from ethnic minorities. Less than half of service providers had a policy for admission of minors to adult wards.
Other concerns identified in this report are child protection issues, the specialist training of staff to deal with these patients, lack of educational arrangements, limited access to legal advice. The MHAC recommends that the Government issue guidelines for these admissions, and that all NHS trusts that are mental healthcare providers have agreed admissions policies for children and minors. Child and Adolescent Mental Health Services (CAMHS) should review access to their services by young people and their families from local Black and minority ethnic groups, and how they respond to cultural needs within the communities they serve, and they should ensure appropriate ethnic monitoring. A final set of recommendations concern the facilities and environment, and staff training and expertise on the wards designated to receive children and minors.show more