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Weighing up the risks of admitting children and young people to mental health inpatient units

This is the last in a series of six articles that aim to encourage nurse leaders to explore how to use research findings to improve practice and services where they work. The series focuses on research that has been funded by the National Institute for Health Research (NIHR) and included in NIHR Dissemination Centre publications. The authors seek to relate the content directly to the Nursing and Midwifery Council’s code of professional standards of practice and behaviour, specifically the themes of practising safely and promoting professionalism and trust

Introduction by Elaine Maxwell, clinical adviser at the National Institute for Health Research Dissemination Centre:

Elaine_Maxwell
Elaine Maxwell

The National Institute of Health Research (NIHR) was set up in 2006 as a health and care research system that focuses on the needs of patients and the public. It aims to produce an evidence base that is translatable into policy and practice. The NIHR Dissemination Centre disseminates the research generated in the form of Signals and Highlights, as well as themed reviews.

In 2018, one themed review brought 30 research studies on severe mental illness together in our report, Forward Thinking. We define severe mental illness as that which results in significant disability in terms of day-to-day functioning. While most of the research we included related to adults, a number of studies considered severe mental illness in children and young people.

Providing care for children and young people with severe mental health is particularly complex and admission to a residential facility is always the last resort, usually because it is thought that the child or young person is at significant risk.

One of the studies we included in our review was the RiSC study (Hannigan et al 2015), which looked at risks for young people moving into, journeying through and out of inpatient mental health care. It demonstrated that there are significant risks to admitting a child or young person to hospital however distressing the mental illness.

In this article, the lead researcher discusses how they undertook the research and how they involved children and young people in deciding what evidence to include, while a consultant nurse considers how these risks can be justified.

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