Children in mental health hospitals at risk of serious rights violations, charity warns

A report by children's rights charity Article 39, part of a three-year project funded by BBC Children in Need, found that while many children are in hospital as "informal patients" and there by "consent", they are often kept locked up, or do not understand their rights and fear being "sectioned" if they try to leave.

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Article 39 said children held on an informal basis, making up around two thirds of the 3,500 children placed in mental health inpatient care each year, are denied the legal safeguards provided to children who are formally detained under the Mental Health Act 1983 – such as the right to an independent mental health advocate and to be given information about their rights.

The report, which is based on the views of advocates in relation to the concerns and issues children bring to them, highlights a range of issues including:

• Children not feeling listened to or involved in the planning of their care and treatment.

• Some children being placed more than 200 miles away from their home, with parents and carers struggling to visit regularly and local authority support to help them do so sometimes being "patchy".

• Restrictions on their day-to-day life which can result in "frustration and boredom".

• Inappropriate use of restraint and seclusion or segregation, and a failure by hospital staff to follow up when complaints are made about it.

• Children being kept in hospital for longer than needed because of lack of appropriate community-based provision to which they can be moved, and/or a lack of coordination between hospitals and local authorities.

The report found that in addition, a number of existing problems facing children and young people in hospitals have been exacerbated by the response to the Covid-19 pandemic, including delayed discharges, contact with family and friends and access to advocacy, echoing the findings of a report published last month by the children's commissioner for England.

"Addressing these problems requires fundamental change that can be difficult to achieve in a system that is complex, disjointed and chronically underfunded," the Article 39 report states.

"Many government commitments made over the last five years have not yet materialised for children and young people. What is clear is that there needs to be urgent consideration of how the existing system of safeguards can be strengthened, including the protections offered to children both before and after admission.

"The inequality in legal protections for children admitted informally to inpatient care, combined with ongoing concerns about the grounds under which they may be admitted, is in urgent need of review, as is children and young people’s access to independent advocacy and the implementation of legislation setting out that children’s care and treatment should be provided in settings that are appropriate for their age and close to home."

Kamena Dorling, head of policy and advocacy at Article 39, who authored the report, said: “These findings follow a number of reports this year, including from the Joint Committee on Human Rights, the children’s commissioner for England and the Care Quality Commission, which all highlight that children in mental health hospitals, including those with autism and/or learning disabilities, are at risk of very serious rights violations.

"Despite successive strong commitments from the government in recent years, the quality of care and treatment for children and young people who have mental ill health remains inadequate and is often scandalous.

"It is time for the government to take real action to ensure that children receive the best possible care and support, close to home and always in settings designed with and for children.

"The government must commence the legislation passed in 2018 on use of restraint and must implement the recommendations of the Independent Mental Health Act review, also issued in 2018, as a matter of urgency, particularly around ensuring all children can access high quality independent advocacy.”