Uncounted and Overlooked: Mental Health Admissions to Acute Paediatric Wards in Ireland

Introduction: Mental health (MH) admissions to acute paediatric wards are increasing globally, yet in Ireland, their true scale remains poorly quantified due to a lack of national data collection. 15 of the 18 acute paediatric units in Ireland lack access to dedicated liaison psychiatry teams, while numerous children and young people (CYP) face multimodal barriers to accessing child and adolescent mental health services (CAMHS) in the community. This places significant pressure upon paediatricians, many of whom report low confidence in managing MH disorders, often doing so in the absence of psychiatric support. Objectives: To clarify current national acute psychiatric care provisions for children and adolescents, we set out to investigate the prevalence of MH admissions to acute paediatric wards in Ireland across four sample timepoints of one- week periods. Additionally we aimed to highlight paediatricians views and experiences in treating CYP with primary MH concerns. Methods: This study used a retrospective mixed methods cross-sectional survey to gather data from each of the 18 paediatric units for CYP aged 4-16 years admitted for MH concerns in Ireland. Four one week sample timepoints were chosen to gather data and explore paediatricians’ experiences in treating MH patients. Data was analysed using IBM SPSS 27. Results: Responses were gathered from all sites surveyed, 100% response rate. CYP presenting for MH concerns accounted for 4.77%-6% of total admissions. 100% (N=18) of Consultant Paediatrician clinicians perceived an increase in MH admissions to acute paediatric units in recent years. 91.67% of Consultant Paediatricians (n=11) disagreed that their team currently receive adequate training regarding management of mental illness. 94.44% of Consultant Paediatricians (n=17) indicated that clinical care for these vulnerable young people experiencing mental illness could be improved. Conclusions: These findings emphasise a rapidly growing demand for MH care within acute paediatric units in Ireland, at a time when clinicians are reporting gaps in training and education regarding child and adolescent mental illness. This mismatch of rising patient needs and healthcare preparedness underscores a clear need for enhanced training, expansion of child and adolescent liaison psychiatry teams nationally, and national data collection to inform sector planning and ensure that these CYP receive care appropriate to their level of clinical need.