Child and Adolescent Mental Health Services: inpatient report

A report recommending improvements to respond better to the needs of children and young people with Learning Disability (LD) and/or autism.


A4.15 Discharge

Information on discharge destination at end of last admission in the study period was available for 78 of the 84 patients admitted to hospital.

For patients of all levels of learning disability and none:

50 (64%) Discharged home

14 (18%) Discharged to social care or residential school placement

14 (18%) Remained as inpatients

Comparing patients of different degrees of learning disability:

Discharge destination →

Level of learning disability ↓

Home Not at home (still inpatients or discharged to residential social care or school placement)
None 18 (75%) 6 (25%)
Mild 14 (67%) 7 (33%)
Moderate 12 (55%) 10 (45%)
Severe/profound 6 (55%) 5 (45%)

Some young people remained in hospital due to a need for ongoing treatment. However others were 'stuck', with their discharges delayed due to lack of available specialist residential education or social care resources to move on to. The individual numbers of these patients may have been small but the situations had a large impact on young people and their families, with relationships between families and staff becoming strained as a result. One parent describing the longer term effect of her young person being 'stuck' in a generally agreed inappropriate setting, " the staff became less compassionate basically and seemed unwilling to recognise his distress as being in response to his feeling 'trapped'. He was isolated from the general population because of his age. The longer this went on the harder he found it and would 'kick off' and we kept being told how difficult he was being but without any real acknowledgement of what was behind it. We feel so guilty every time we have to leave him with those people". Impact was also described on other patients needing to use inpatient resources as well as outpatient CAMH/ LD CAMH services who had to do in-reach work to support them.

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