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Working together better for mental health in children and young people during a pandemic: experiences from North Central London during the first wave of COVID-19
  1. Monika Gorny1,
  2. Sarah Blackstock2,
  3. Arun Bhaskaran2,
  4. Imogen Layther3,
  5. Mimoza Qoba1,4,
  6. Carly Vassar3,
  7. Jacob Ellis2,
  8. Joanna Begent2,
  9. John Forrester3,
  10. Jon Goldin3,
  11. Zoe Hallet3,
  12. Tina Read5,
  13. Sally Hodges6,
  14. Michael Groszmann2,
  15. Lee Duncan Hudson3
  1. 1Royal Free Hospital, London, UK
  2. 2University College London Hospital NHS Trust, London, UK
  3. 3Great Ormond Street Hospital for Children, London, UK
  4. 4Royal Free Hospital NHS Trust, London, UK
  5. 5Barnet Enfield and Haringey CAMHS, Enfield, London, UK
  6. 6Tavistock and Portman NHS Trust, London, UK
  1. Correspondence to Dr Monika Gorny; monika.gorny2{at}nhs.net

Abstract

Direct risk from infection from COVID-19 for children and young people (CYP) is low, but impact on services, education and mental health (so-called collateral damage) appears to have been more significant. In North Central London (NCL) during the first wave of the pandemic, in response to the needs and demands for adults with COVID-19, general paediatric wards in acute hospitals and some paediatric emergency departments were closed. Paediatric mental health services in NCL mental health services were reconfigured. Here we describe process and lessons learnt from a collaboration between physical and mental health services to provide care for CYP presenting in mental health crisis. Two new ‘hubs’ were created to coordinate crisis presentations in the region and to link community mental health teams with emergency departments. All CYP requiring a paediatric admission in the first wave were diverted to Great Ormond Street Hospital, a specialist children’s hospital in NCL, and a new ward for CYP mental health crisis admissions was created. This brought together a multidisciplinary team of mental health and physical health professionals. The most common reason for admission to the ward was following a suicide attempt (n=17, 43%). Patients were of higher acute mental health complexity than usually admitted to the hospital, with some CYP needing an extended period of assessment. In this review, we describe the challenges and key lessons learnt for the development of this new ward setting that involved such factors as leadership, training and also new governance processes. We also report some personal perspectives from the professionals involved. Our review provides perspective and experience that can inform how CYP with mental health admissions can be managed in paediatric medical settings.

  • mental health
  • COVID-19 pandemic
  • paediatrics
  • North Central London

Data availability statement

Data are available on reasonable request.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Data availability statement

Data are available on reasonable request.

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Footnotes

  • Contributors LDH, MG, SB and AB conceived the piece. MG, SB and LDH led the write up. Data identification was supported by MG, SB, AB, CV, IL and SH. MG, SB and LDH worked on the first draft, and all authors contributed to the final manuscript and were involved with the clinical work and topic discussed. All authors are involved in revising the contents of the manuscript and take responsibility for its content.

  • Funding This work was supported by Great Ormond Street Hospital Charity grant number VC0321.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.