Meeting the mental health needs of children and young people in acute hospitals: these patients are all our patients

Joint statement by RCEM, RCPCH and RCPsych

The Royal Colleges of Emergency Medicine, Paediatrics and Child Health, and Psychiatrists recognise the enormous toll that the pandemic has taken on the mental health of children and young people across the country. Our members are seeing more patients in distress and with mental ill health, accessing services at more advanced stages of illness. We know that as Child and Adolescent Mental Health Services struggle to keep up with unprecedented demand, more children and young people are presenting to Emergency Departments with complex psychosocial crises. More are being admitted to paediatric wards with both physical and mental health needs or simply because it is the safest place for them at that moment in time. Long before the pandemic, mental health and crisis support for children and young people in acute care was often inadequate, and pressure on the system has grown considerably.

Regardless of where children and young people present to care or what their specific health needs are, we must work together to ensure they receive the highest quality care, from qualified clinicians, as quickly as possible.

Children and young people are too vulnerable to be told to try different doors for separate needs or to be left to wait without any support. These patients are all our patients and we must work together to ensure they receive the right treatment, in the right place, at the right time.

What RCEM, RCPCH and RCPsych are doing:

• Proactively engaging with NHS leaders working to improve systems.
• Emphasising the importance of expanding paediatric liaison and CAMHS across the UK, to achieve 24/7 access to support for children and young people and professionals, and improving access to appropriate inpatient provision
• Calling for mental health leadership across departments to be strengthened, the recruitment of staff able to bridge the gap between services and accelerating the roll-out of integrated models of care.
• Continuing to make the case for targeted investments to be made where required.
• Working jointly to ensure appropriate training is available across specialties.

What can individual clinicians do?

• Keep children and young people at the centre of all our decision making.
• Organise and access training on CYP mental health
• Collaborate and improve understanding between colleagues working in acute trusts and CAMHS

We need to proactively collaborate to ensure referral and commissioning pathways are as smooth and timely as possible. We also need to recognise that while our colleagues are facing the same pressures, we must do everything within our gift to meet the needs of the children and young people in front of us until specialist support is available.

We know that this is often far more difficult to do in practice than it should be and are campaigning to ensure systems are in place to better support you as clinicians and your wider teams. As we weather this storm together, we must maintain our focus on securing the best outcomes for all children and young people.