Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

Accept all cookies Reject all non-essential cookies

Far from Home: Adolescent Mental Health Inpatient Care Access

  • Mental Health
  • Mental Health across the Life Course
  • Methods and Tools

This study investigated the impact of admissions of young people (aged 13-17) to psychiatric inpatient units located far from home (over 50 miles or out of area) or to adult wards. National policy discourages such admissions due to concerns about isolation, poor clinical outcomes, and disruption to continuity of care. However, limited capacity in child and adolescent mental health services (CAMHS) often leads to these placements.

The study used a 13-month national surveillance approach, collecting data from Child and Adolescent Consultant Psychiatrists. It also conducted in-depth interviews with 30 young people, 20 parents/carers, and 68 healthcare professionals to explore the real-world impact of these admissions.

The research aimed to establish the scale, costs, and effects of these admissions, offering insights to improve service provision, clinical guidelines, and policy.

Impact and Implementation

  • Developed a standardised information template for inpatient units, now being considered by NHS England.
  • Findings highlight the need for pre-admission guidance for clinicians and structured decision-making processes.
  • Strengthened partnerships with NHS England, the Royal College of Psychiatrists, and CQC to inform national policy.
  • Study data is being shared with individual Provider Collaboratives to support local service improvements.
  • Public and patient involvement (PPI) shaped study design, results, and dissemination strategies.

Next Steps

  • Creating videos and infographics to present findings to young people and families.
  • Developing checklists to support clinicians in making admission decisions.
  • Providing clear guidance for inpatient units on how to support families visiting young people placed far from home.
  • Promoting best practices in young people’s involvement in admission decisions.
  • Researcher Josephine Holland is undertaking a PhD at the University of Nottingham based on this study.

Project lead / contact: James Roe, The University of Nottingham,  James.Roe@nottingham.ac.uk

Website: arc-em.nihr.ac.uk/research/far-away-home

ARC theme: Mental health across the life course

Completed Project

Key Findings

  • 290 adolescents admitted to distant psychiatric units/adult wards (7.83 per 100,000)
  • 73% female, predominantly aged 16-17
  • 38% placed over 100 miles from home, 8% over 200 miles
  • Common diagnoses: depression (34%), suicide risk (80%), psychotic symptoms (22%)
  • 41% waited over a week for appropriate placement
  • 55% temporarily held in general hospital settings
  • Families experienced limited involvement in decisions and lack of information
  • Distance created practical/financial challenges for families, though some found it provided respite
  • Clinicians struggled to maintain continuity of care with community teams
  • Over-representation of Black African males among those admitted

ARC OxTV Associated Project

Associated projects are projects which the ARC has helped support in some way, but does not  itself directly fund or run.