Objectives The University College London Hospital (UCLH) Child and Adolescent Psychological Medicine service provides psychiatric care to individuals under the age of 18. We provide mental health care for children and young people under the care of a paediatrician in a variety of paediatric settings; outpatient clinics, the Emergency Department (ED) or inpatient wards.
The aim of this audit project were:
Gather and report all data associated with the clinical work undertaken in this division by investigating the number of new referrals presenting to the team from November 2016 – May 2022
Describe the demographic characteristics and data on patient visits of the new referrals
Compare this data with trends observed locally (North Central London hospitals) and nationally
Methods The data collected was anonymised as the aim of the project was to identify broader trends under the framework of a service development project.
Using the list of patients from the weekly Multi-Disciplinary Team (MDT) meeting on Epic, we collected the number of new referrals (crisis and planned) each month, from March 2020 to May 2022. Data of new referrals from November 2016 to April 2019 was available from a previous service development project, and this was combined with our data for a broader view of trends over time.
We then collected data on patient demographic and hospital visit for both crisis and planned patients, by exploring the encounters, progress notes and media of each patient to understand the reason for their presentation to hospital, level of social care involvement and length of stay.
Lastly, we summarised the data and compared it to national (NHS) and local (North Central London Trusts) referral data trends.
Results Within the trust, we found an overall increase in crisis cases and decrease in planned cases, from November 2016 to March 2021. We also found that at any point in time, the number of crisis cases was inversely proportional to the number of planned cases.
In terms of demographics, 81% of the patients who present to the UCH children and adolescent psychiatry team were female, with a mean age of 15.07 (SD=2.02) years. 62% of patients live in either Camden or Islington. Furthermore, 14% were in care, 64% had some level of service involvement, and 22% had no service involvement.
Most patients presented with an overdose (30%), suicide ideation (18%) and self-harm (15%), and the mean number of overnight stays was 2.75 (SD=5.40) days.
The increase in frequency of young people presenting in mental health crisis is comparable to national statistics. According to NHS Digital, the number of children and young people receiving mental health care has both increased by approximately 70% since 2017.
Conclusions In conclusion, the overall number of patients referred to the UCLH Child and Adolescent Psychiatry team has increased since November 2016. Referrals of crisis patients have increased, while referrals of planned patients have demonstrated a falling trend. Our data are comparable with local and national referral trends.
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