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Provision of child and adolescent mental health in-patient services in England between 1999 and 2006

Research Fellow, Royal College of Psychiatrists’ Research and Training Unit (CRTU), London

Paul Lelliott

Consultant Psychiatrist and Director of CRTU, 4th Floor, Standon House, 21 Mansell Street, London E1 8AA, email: p.lelliott{at}cru.rcpsych.ac.uk

Debbie Bannister

Research Assistant, CRTU, London

Andrew Cotgrove

Consultant Child and Adolescent Psychiatrist, CRTU, London

Hannah Farr

Research Assistant, CRTU, London

Simon Tulloch

Research Worker, CRTU, London

Declaration of interest

None.

AIMS AND METHOD

In 1999, child and adolescent mental health (CAMH) in-patient provision was unevenly distributed across England. A repeat of a 1999 bed count survey was conducted in 2006 to determine whether change had occurred in response to government policy.

RESULTS

Total bed numbers in England were found to have increased by 284; 69% of the increase is due to the independent sector, whose market share has risen from 25% in 1999 to 36% in 2006. Regions with the highest number of beds in 1999 have increased bed numbers more than areas with the lowest number of beds in 1999 (8.3 v. 3.6 beds per million population). In units that admit only children under the age of 14, there has been a 30% reduction in beds available (123 to 86).

CLINICAL IMPLICATIONS

Inequity in provision of CAMH inpatient services has increased despite government policy to the contrary. We speculate that this might be partly due to fragmented and local commissioning, and the effects of market forces operating as a result of increasing privatisation.

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