Acute inpatient care for children and adolescents

Inpatient treatment of children and adolescents forms an important part of modern psychiatric care. However, practices are changing with increasing demands for admission, and higher numbers of suicidal adolescents, with a greater degree of complexity and higher levels of violence and self-harm. There is also a drive for shorter admissions, partly driven by costs and resource limitations. Inpatient care is a complex activity, and understanding the dynamics and group dynamics of an inpatient unit is vital to any successful outcome. Child and adolescent units provide a variety of therapeutic approaches delivered by a multidisciplinary team. Integration of the therapeutic modalities is essential. In this age group, inpatient care is divided by age. Specialized services include eating disorder, forensic/secure, learning disability, and occasionally autism units. The outcome of inpatient care is favourable, although costly, and requires managed integration with outreach and community psychiatric services.