Intensive Psychiatric Care Unit for adolescents in Scotland: FOI release

Information requested

“1. There are no secure in-patient units in Scotland separate from adults for adolescents suffering from mental health problems. When was this first identified as a problem in Scotland?

2. A new national Intensive Psychiatric Care Unit for adolescents is being built in Scotland.
a) How many places will be available for adolescents?
b) How was the demand for such places estimated?
c) What were the factors that led to the citing of the Unit in the location chosen?
d) What provision will there be for visitors and patients to ensure privacy during visits?
e) Were interim arrangements considered to provide Intensive Psychiatric Care Units for adolescents separate from adults pending the opening of the national one?”

Response

The answers to your questions are:

1. There are no secure in-patient units in Scotland separate from adults for adolescents suffering from mental health problems. When was this first identified as a problem in Scotland?
The Forensic CAMHS Report March 2010 was published on 12 March 2010 with the remit of considering the need and demand for Secure Inpatient Beds for Children and Young People in Scotland. One of the conclusions of this report was that although alternatives to secure inpatient care had been considered and/or tested, they would be unable to meet adolescent patient’s clinical needs.

2. A new national Intensive Psychiatric Care Unit for adolescents is being built in Scotland.

a) How many places will be available for adolescents?
The request refers to a “national Intensive Psychiatric Care Unit for adolescents”. We can confirm that the National Secure Adolescent Inpatient Service (NSAIS) will provide 12 beds. This bespoke unit will provide care for adolescents who might otherwise have been admitted to an Intensive Psychiatric Care Unit.

b) How was the demand for such places estimated?
Demand has been assessed by NHS Ayrshire & Arran. In preparing its business case for the NSAIS, various sources of information were used. Since the Mental Health (Care and Treatment) (Scotland) Act 2003 came into force, admissions of under-18 year-olds admitted to non-specialist settings (including locked adult psychiatric wards) have been monitored. Numbers of detained patients transferred to English hospitals have also been counted. In addition, surveys have been undertaken to ascertain any patients whose needs may have been met in other ways. Demand was compared (‘benchmarked’) with that of England as part of the business case.

c) What were the factors that led to the citing of the Unit in the location chosen?
NHS National Services was responsible for commissioning the NSAIS. In 2019, a rigorous and transparent process of national commissioning was undertaken, which involved all Scottish Health Boards. After considering a range of options for the type of provision and its location, it was decided that NHS Ayrshire & Arran should be invited to develop the proposed national service. NHS Ayrshire & Arran is currently developing its development and construction plans for the new unit with a view to the NSAIS commencing in 2021.

d) What provision will there be for visitors and patients to ensure privacy during visits?
The proposed design by NHS Ayrshire & Arran includes dedicated visiting rooms which will be welcoming to families and allow young people to spend time with their parents/carers, siblings and other visitors. Contacts would be planned and supervised in ways which would ensure the privacy, safety and security of everyone who visits, stays and works in the NSAIS.

e) Were interim arrangements considered to provide Intensive Psychiatric Care Units for adolescents separate from adults pending the opening of the national one?
To date a number of interim arrangements have been employed across Scotland. These include caring for young people within separate ‘suites’ in adult Intensive Psychiatric Care Units, and ensuring that they have input from specialist Child and Adolescent Mental Health Services (CAMHS), social work and education. Vulnerable young people in such situations have access to independent advocacy to ensure that their views are heard. In some cases, under-18 year olds have been provided with treatment via ‘in-reach’ by CAMHS to secure schools or other specialist residential accommodation, or via intensive community services as an alternative to hospital.

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