6129 Patterns of mental health admissions amongst children and young people in England 2012 to 2022

Objectives Children and Young People (CYP) with mental health crises frequently require admission to acute general inpatient wards. Although there are concerns these admissions have increased, particularly during the COVID-19 pandemic, a detailed description of these patterns is lacking.1–3 The aim of this study is to describe the changing burden of mental health admissions amongst CYP in England, in order to inform the development of new models of care for these patients, as part of the Mental Health Admissions to Paediatric Wards Study (MAPS). Methods We used Hospital Episode Statistics (HES) data, containing 97% of hospital activity in England. Data were available on all inpatient admissions amongst CYP aged 5 to 18 (inclusive) from April 2012 to March 2022. We identified mental health admissions using treating specialty or primary reason for admission within HES (or secondary diagnosis for self-harm admissions), coded using the International Classification of Diseases 10, and categorised using the Global Burden of Disease Study 2019 cause hierarchy. We describe total admissions and change over time, by cause, sex, age, ethnicity, index of multiple deprivation (IMD) quintile, and across Integrated Care Boards (ICB) in England. Results We identified 342,511 acute inpatient admissions for any cause in CYP aged 5 to 18 in 2021–22 in England, of which 39,925 (11.7%) were due to mental health conditions. 21,337 (53.4%) of these admissions were due to self-harm. 79.1% of mental health admissions were among females, (compared with 52.6% of all admissions) and 76.7% were amongst white CYP, (compared with 69.2% of all admissions). Admissions by IMD quintile were similar between mental health and non-mental health causes. We found large variation in mental health admission rates between ICBs. Mental health admissions increased by 65.0% since 2012, compared with a 10.1% increase in all cause admissions. Increases were steepest in females aged 11 to 15, where admissions have more than doubled over this period, and now account for 28.3% of all acute inpatient admissions. Conditions that showed the steepest change in admissions included eating disorders, which have increased 6 fold since 2012, and doubled since the start of the pandemic. Conclusion We found large increases in the number of CYP admitted to acute inpatient units due to mental health problems, particularly in females aged 11 to 15. Further work is needed to understand the factors driving these trends, and how to meet challenges in providing safe care to CYP with mental health concerns in these settings. References Hudson LD, Chapman S, Street KN, et al. Increased admissions to paediatric wards with a primary mental health diagnosis: results of a survey of a network of eating disorder paediatricians in England. Archives of Disease in Childhood 2022;107(3):309–10. Ford T, John A, Gunnell D. Mental health of children and young people during pandemic. British Medical Journal Publishing Group 2021. Royal College of Paediatrics Child Health. A snapshot of general paediatric services and workforce in the UK. Royal College of Paediatrics and Child Health London; 2020.