To think there should be mental health wards for 18-25 year olds

[Worriedmother666]

To bridge the huge gap between child and adult mental health services.

The transition from CAMHS to adult mental health provision can be fraught and scary. It understandably provokes a lot of anxiety

There are no specific wards for that age bracket , however some services try plan the transition

No YANBU. That would seem very sensible.

I just think it’s scary to be put
In a ward with people decades older. From what I’ve seen as well the staff don’t even take into account someone being a lot younger.

Yes! My DD is about to begin transitioning from CAMHS to adults (anorexia) and I'm really anxious about what that means in terms of support provided and if she is admitted to hospital - not being on a paeds ward would be a very different experience for her....

myrtleWilson Hope it goes okay for her.

Where does the additional funding come from to build a d staff such a unit
Would it be done on a regional basis to group a few 18-25yo wards together in 1 facility. Or open an additional ward on site
How many beds are required, is there enough demand?What about under occupancy?over occupancy?

That’s a really good idea. The prison service recognises this interim period - makes sense mental health services would.

Write to your MP / the health secretary? Top tip: if you write to your MP and ask him to pass it to the health secretary, you’ll get a ministerial response meaning a minister will def see the letter.

But you could argue that about any treatment, not just mental health. I’m sure it’s scary, but not any more or less scary than oncology, or orthopaedics or gastroenterology.

So yes, in a ideal world maybe, but people will still be decades older than you at 25 and there simply isn’t the money to create and entire mid way service across all specialisms.

I don't think it would need to be a whole separate unit @HeelsHandbagPerfumeCoffee, it could be wards on an existing unit. And I do think its more scary than oncology, orthopedics etc due to the unwellness of the patients and the nature of their illness.

I disagree, @PotteringAlong. Going into hospital with a mental health condition makes you uniquely vulnerable in a different way than a physical condition, however scary.

There’d need to be enough patients to justify a designated ward,and what if there aren’t always many inpatient in that age group at a given time? It is not feasible to have an under occupied ward
So in which case the provision would be better regionally to ensure occupancy .Meaning more travel,less local provision
A ward requires consultant psychiatrist , SpR, nurses,HCA,OT,pharmacy visits, domestics and crucially enough patients .

@HeelsHandbagPerfumeCoffee

There’d need to be enough patients to justify a designated ward,and what if there aren’t always many inpatient in that age group at a given time? It is not feasible to have an under occupied ward So in which case the provision would be better regionally to ensure occupancy .Meaning more travel,less local provision A ward requires consultant psychiatrist , SpR, nurses,HCA,OT,pharmacy visits, domestics and crucially enough patients .

It could be used as a hub for CAMHS, outpatient therapies and support as well, and possibly include transition services for young people with ASD and possibly learning disabilities too under the same roof.

It's a hugely underfunded sector and properly funded specialist and dedicated mental health support for this age group would probably save more money long term than it would cost to provide the service.

But that would be too sensible.

The transition from CAMHS to AMHS can be problematic and there has been trial initiative of service up to age 25yo however extending the upper age impacted upon service ability to take new referrals as they were at capacity

Office of National Statistics reports that rates of mental illness are higher in the 17-19 age group than in the adolescents and children age. So extending the upper age limit impacts upon service capacity and ability to take new referrals eg a funding and capacity issue

It seems like a good idea on the face of it. Forgive me not being too experienced however, but surely if the transition from CAMHS to Adult Services is difficult, then it would be similar for another service, with the added complication of having to transition again in 8 years time.

And likely transition points are also the most risky points where people fall through the net, and disappear from care.

I think monies would probably be better spent in making current transition as seamless as possible, with clear handover dates, and the flexibility to say an individual will stay under CAMHS past their 18th Birthday, if it would be too distressing or otherwise to move straight away.

Flexibility to stay under CAMHS will impact their ability to accept referrals
Teams have a finite amount of referrals they can safely work with,were demand exceed capacity you get waiting lists.
It is the getting lost to ongoing services that’s part of the issue, and the two services are different in in experience and who they serve

Being moved from one system to the next for vulnerable teens in our experience was ruthless and very little thought for the welfare of the patients was evident

CAMHS informed us note informed not discussed that DD. was being transferred early 2 months prior to her 18th birthday during lockdown when she needed stability the most as we’re a highly vulnerable household

The new team decided without discussion to stop sleep meds instantly and tried to change her anxiety meds too, tried to remove diagnosis I could go on

In the end I had to step in and explain that they had destroyed any trust by their actions in a very complex young person

A hub would be a fantastic idea, I’ve worked on an acute psychiatric ward previously and would love that sort of facility here

Sadly we don’t even have a team with an interest in autism now either in CAMHS or adult services which is a travesty

There are so many autistic people in our area that would benefit from access to any service that actually understands them, it really is an unreasonably under resourced condition

I think 18-25 year old teams are a fairly good idea. And it's basically what Early Intervention in Psychosis teams are in some ways, although people who get ill at CAMHS age end up excluded and they have a higher age limit.

However, I'm less enamoured with the idea of 18-25 year old wards. Firstly there are obvious resourcing issues. But secondly from a social dynamics point of view, I'm not sure it would be the best. From my experience, a lot of the more school yard, cliquey or bullying behaviour on wards has been amongst the younger patients and I can see such an environment being prone to being quite toxic. I also think when it comes to group therapy and similar, then there is value to being able to hear from people with lived experience several years down the line.

Really I'd just be more pro properly funded services and potentially especially intense support during the first period of a serious mental illness.

EIS is an excellent model,it’d exclude CAMHS clients as not 1st presentation

I’m not sure what a hub adds,it doesn’t address waiting lists etc,or capacity issues

For example the CMHT being in same building as LD team doesn’t in itself mean they’ll share resources or MDT working. As the LD team will have a referral criteria, the CMHT will have a referral criteria and the teams have their own individual staff who won’t work across teams. Sure there may be joint working on occasion but being in same building , same location doesn’t make teams work jointly. All teams have referral criteria and thresholds. Being adjacent to each other doesn’t in itself change that

St Andrews heathcare offers something similar.

They’re private and charge NHS a fortune

Some kind of differentiation for age would be brilliant. If there was the space and funding.

I've been a mh support worker. We had patients ranging form mid 20s - mid 80s. Trying to arrange activities for them all was not easy! Either more staff so more activities can run, or separate services would have been amazing!

Someone mentioned oncology upthread - but as far as I understand it, this is a model used by oncology - teenage cancer trust wards operate from 13- 24 I believe?

heels I completely get where you're coming from in terms of cost, take up, location etc.. But the underlying issue is that for too many young people still in need of support, there is a cliff edge between CAMHS and adults, or CAMHS and community. For example, my daughter currently receives around 9 hours of intervention per week for her eating disorder. In a months time that will drop significantly - and I understand why, resources - but the potential impact on my DD could be significant. I expect she will restrict eating further, potentially need admitting etc etc. She just isn't in a place to cope without significant support at the moment so that cliff edge is looking pretty terrifying to me.

I completely agree with the cliff edge Analogy actually
Look I’m not seeking to deflate people, I’m simply introducing the realistic view what it’s actually like.
And it all essentially comes down to money and resources, there’s simply not enough money to meet demand
Recruitment and retention of staff are issues
CCG and health budgets were savagely decreased

People are happy to stand and clap, some platitudes about isn’t nhs great. Clapping stops problems still remain. Systemic underfunding

People need to contact their mp, their councillor,the CCG and complain a lot and frequently about underfunded MH provision

Agree 100%, especially for inpatient facilities. I know someone who spent an extended period of time (almost two years) in a facility as a teenager on a compulsory section. A few months short of her 18th birthday she was transferred to a mixed sex adult secure ward.

I went to see her in there, it was terrifying - though I personally only saw the visitor room. She said she was the youngest person in there by over a decade, most patients were male and outbreaks of violence or violent behaviour were a daily occurrence. She was the only person in there who didn't have a criminal conviction for some form of violence (going by what the other patients told her, which may of course not have been totally accurate).

She said what kept her safe was the fact that due to her being so young, the other patients assumed she had done something absolutely heinous - she hadn't, she'd never hurt anyone but herself - and after trying and failing to get her to talk about this supposed terrible crime that never happened, they avoided confrontation with her on the basis she must be lying and extremely dangerous!