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2.2.42 Psychiatric Care for Children

See also the National Service Framework for children, young people and maternity services (Children's NSF) which sets out standards for hospital services in respect of individual children's safety and well-being.

Children who require treatment as an in-patient in a psychiatric setting will usually be admitted on a voluntary basis, otherwise the Mental Health Act 1983 or the Children Act 1989 will apply. The admission criteria will differ, such as acute (crisis or short term), for eating disorders or challenging behaviour. Age ranges can vary considerably and some children may be admitted to an adult psychiatric setting. Catchment areas for some hospitals may cover a regional or national area depending on the specialism.

Where consent for treatment is required, it should be clarified by the lead professional (e.g. LA children's social care, child and adolescent mental health services (CAMHS)) whether this is being carried out under the Mental Health Act 1983 or the Children Act 1989.

If any child who is considered to be Fraser Competent is unwilling to remain as an informal patient consideration should be given to use the Mental Health Act 1983. For children under 16 where a Fraser competent child wishes to discharge him or herself as an informal patient from hospital, the contrary wishes of those with parental responsibility will ordinarily prevail. Where there is dispute consideration should be given to use the Act. Similarly if a 16 or 17 year old in unwilling to remain in hospital as an in-patient, consideration may need to be given whether he or she should be detained under the Act.

Children in psychiatric settings may need to be isolated from other patients. The young person may require care on an individual basis on the unit and facilities to allow for this can be used as per Trust policy. Staff should be appropriately trained to meet their needs and safeguard their welfare. When a child is admitted to psychiatric settings where adults are inpatients, a risk assessment must be undertaken to avoid the child being placed in vulnerable situations.

Children admitted to psychiatric settings may disclose information about abuse or neglect concerning themselves or others. Disclosures may be made when the child feels it is safe to talk or when the child is angry, distressed or anxious. All allegations should be treated seriously and usual procedures followed.