eprintid: 10205128 rev_number: 9 eprint_status: archive userid: 699 dir: disk0/10/20/51/28 datestamp: 2025-02-21 11:28:19 lastmod: 2025-02-21 11:28:19 status_changed: 2025-02-21 11:28:19 type: article metadata_visibility: show sword_depositor: 699 creators_name: Ward, Joseph L creators_name: Vazquez-Vazquez, Adriana creators_name: Phillips, Kirsty creators_name: Settle, Kate creators_name: Pilvar, Hanifa creators_name: Cornaglia, Francesca creators_name: Gibson, Faith creators_name: Nicholls, Dasha creators_name: Roland, Damian creators_name: Mathews, Gabrielle creators_name: Roberts, Helen creators_name: Viner, Russell M creators_name: Hudson, Lee D title: Admission to acute medical wards for mental health concerns among children and young people in England from 2012 to 2022: a cohort study ispublished: pub divisions: UCL divisions: B02 divisions: D13 divisions: G25 keywords: Science & Technology, Life Sciences & Biomedicine, Pediatrics, ANOREXIA-NERVOSA note: Copyright © 2025 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license abstract: Background: There are challenges in providing high quality care for children and young people who are admitted to acute medical wards for mental health concerns. Although there is concern that these admissions are increasing, national data describing these patterns are scarce. We aimed to describe trends in these admissions in England over a 10-year period, and to identify factors associated with repeat admission and length of stay. Methods: In this cohort study we used data on all admissions to medical wards in England among children and young people aged 5–18 years from April 1, 2012, to March 31, 2022. We classified admissions for mental health concerns using the Global Burden of Disease Study cause hierarchy. We described national trends in admissions for mental health concerns over time by sex, age, ethnicity, and index of multiple deprivation quintile. We examined associations between sociodemographic and clinical factors and odds of the admission lasting more than 1 week, as well as hazard ratios of repeat admissions, using mixed-effects models. Findings: We identified 342 511 admissions for any cause in children and young people aged 5–18 years in 2021–22 in England, of which 39 925 (11·7%) were for mental health concerns. 21 337 (53·4%) admissions for mental health concerns were due to self-harm. Between 2012–13 and 2021–22, annual admissions for mental health concerns increased from 24 198 to 39 925 (65·0% increase), whereas all-cause admissions increased from 311 067 to 342 511 (10·1% increase). Increases were particularly steep in females aged 11–15 years, rising from 9091 to 19 349 (112·8% increase), and for eating disorders, rising from 478 to 2938 (514·6% increase). In 2021–22, 3130 (7·8%) admissions for mental health concerns lasted longer than 1 week, compared with 12 044 (3·5%) all-cause admissions. Of 239 541 children and young people who were admitted for mental health concerns between 2012–13 and 2021–22, 32 107 (13·4%) had a repeat admission within 6 months. The odds of long-stay admission and hazard ratios for being readmitted were significantly higher for children and young people aged 11–15 years, those who were female, those from less deprived areas, and those with eating disorders than among other groups. Interpretation: We found large increases in the number of children and young people admitted to acute medical wards for mental health concerns over a 10-year period. Further work is needed to understand factors driving these trends and how to improve care for children and young people with mental health concerns admitted to medical wards. Funding: National Institute for Health and Care Research date: 2025-02 date_type: published publisher: ELSEVIER SCI LTD official_url: https://doi.org/10.1016/s2352-4642(24)00333-x oa_status: green full_text_type: pub language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 2356813 doi: 10.1016/S2352-4642(24)00333-X medium: Print pii: S2352-4642(24)00333-X lyricists_name: Hudson, Lee lyricists_name: Roberts, Helen lyricists_name: Ward, Joseph lyricists_id: LHUDS06 lyricists_id: HROBE33 lyricists_id: JWARD28 actors_name: Ward, Joseph actors_id: JWARD28 actors_role: owner funding_acknowledgements: [National Institute for Health and Care Research] full_text_status: public publication: The Lancet Child & Adolescent Health volume: 9 number: 2 pagerange: 112-120 pages: 9 event_location: England issn: 2352-4642 citation: Ward, Joseph L; Vazquez-Vazquez, Adriana; Phillips, Kirsty; Settle, Kate; Pilvar, Hanifa; Cornaglia, Francesca; Gibson, Faith; ... Hudson, Lee D; + view all <#> Ward, Joseph L; Vazquez-Vazquez, Adriana; Phillips, Kirsty; Settle, Kate; Pilvar, Hanifa; Cornaglia, Francesca; Gibson, Faith; Nicholls, Dasha; Roland, Damian; Mathews, Gabrielle; Roberts, Helen; Viner, Russell M; Hudson, Lee D; - view fewer <#> (2025) Admission to acute medical wards for mental health concerns among children and young people in England from 2012 to 2022: a cohort study. The Lancet Child & Adolescent Health , 9 (2) pp. 112-120. 10.1016/S2352-4642(24)00333-X <https://doi.org/10.1016/S2352-4642%2824%2900333-X>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10205128/3/Ward_1-s2.0-S235246422400333X-main.pdf