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What do we know about the risks for young people moving into, through and out of inpatient mental health care? Findings from an evidence synthesis

Edwards, Deborah Jayne, Evans, Nicola, Gillen, Elizabeth, Longo, Mirella, Pryjmachuk, Steven, Trainor, Gemma and Hannigan, Ben 2015. What do we know about the risks for young people moving into, through and out of inpatient mental health care? Findings from an evidence synthesis. Child and Adolescent Psychiatry and Mental Health 9 , 55. 10.1186/s13034-015-0087-y

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Abstract

Background Young people with complex or severe mental health needs sometimes require care and treatment in inpatient settings. There are risks for young people in this care context, and this study addressed the question: ‘What is known about the identification, assessment and management of risk in young people (aged 11–18) with complex mental health needs entering, using and exiting inpatient child and adolescent mental health services in the UK?’ Methods In phase 1 a scoping search of two electronic databases (MEDLINE and PsychINFO) was undertaken. Items included were themed and presented to members of a stakeholder advisory group, who were asked to help prioritise the focus for phase 2. In phase 2, 17 electronic databases (EconLit; ASSIA; BNI; Cochrane Library; CINAHL; ERIC; EMBASE; HMIC; MEDLINE; PsycINFO; Scopus; Social Care Online; Social Services Abstracts; Sociological Abstracts; OpenGrey; TRiP; and Web of Science) were searched. Websites were explored and a call for evidence was circulated to locate items related to the risks to young people in mental health hospitals relating to ‘dislocation’ and ‘contagion’. All types of evidence including research, policies and service and practice responses relating to outcomes, views and experiences, costs and cost-effectiveness were considered. Materials identified were narratively synthesised. Results In phase 1, 4539 citations were found and 124 items included. Most were concerned with clinical risks. In phase 2, 15,662 citations were found, and 40 addressing the risks of ‘dislocation’ and ‘contagion’ were included supplemented by 20 policy and guidance documents. The quality of studies varied. Materials were synthesised using the categories: Dislocation: Normal Life; Dislocation: Identity; Dislocation: Friends; Dislocation: Stigma; Dislocation: Education; Dislocation: Families; and Contagion. No studies included an economic analysis. Although we found evidence of consideration of risk to young people in these areas we found little evidence to improve practice and services. Conclusions The importance to stakeholders of the risks of ‘dislocation’ and ‘contagion’ contrasted with the limited quantity and quality of evidence to inform policy, services and practice. The risks of dislocation and contagion are important, but new research is needed to inform how staff might identify, assess and manage them.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Healthcare Sciences
Information Services
Medicine
Subjects: R Medicine > RA Public aspects of medicine
R Medicine > RT Nursing
Uncontrolled Keywords: Contagion; Child and adolescent mental health services; Education; Families; Friends; Identity; Inpatient; Normal life; Risk; Stigma
Additional Information: This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Publisher: BMJ Publishing Group
ISSN: 1753-2000
Funders: NIHR HS&DR Programme
Date of First Compliant Deposit: 30 March 2016
Date of Acceptance: 8 December 2015
Last Modified: 21 Jun 2019 21:01
URI: http://orca.cf.ac.uk/id/eprint/84260

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