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Children admitted to high security (special) hospital
Claire Dimond1, Martin Butwell
1CAMHS, Lanesborough Wing, St George's Hospital, London SW17 0QT.
Insights
Children admitted to high-security psychiatric hospitals in England experienced significant childhood disruption, including early offenses and frequent caregiver changes. This highlights the need for specialized, sensitive care for these vulnerable youth.
Area of Science:
- Forensic Psychiatry
- Child and Adolescent Psychiatry
- Clinical Psychology
Background:
- Special hospitals in England provide high-security psychiatric care.
- Understanding the characteristics of children in these settings is crucial for service development.
Purpose of the Study:
- To examine the demographics and background characteristics of children admitted to high-security hospitals in England.
- To compare these children with a matched adult group.
Main Methods:
- Analysis of the special hospital case register for 46 children admitted between 1983 and 1999.
- Matching children with an adult comparison group based on sex, legal classification, and mental disorder classification.
Main Results:
- Children admitted to high-security care had earlier convictions for offenses like criminal damage and violence.
- They were more likely to have experienced caregiver changes, placement in children's homes, and less likely to live with family at 16.
- These children exhibited significant childhood disruption and high utilization of multi-agency services.
Conclusions:
- Children in high-security settings face considerable childhood adversity.
- There is a need to develop developmentally sensitive services tailored to the unique needs of children requiring high-security psychiatric care.
Introduction:
The Special Hospitals in England provide psychiatric treatment in high security. The aim of this study was to examine the demographics and background characteristics of children admitted to high security hospitals in England, using the special hospital case register.
Method:
Forty-six children (the subject group) were admitted to a high security hospital under the MHA (1983) classification of disorder of mental illness and/or psychopathic disorder between 1983 and 1999, 33 (72%) of whom were male. A comparison group of adults was matched on sex, legal classification of detention and MHA 1983 classification of disorder.
Results:
The children were admitted for a similar range of offences to those of the comparison group. However, the children had received convictions for criminal damage and violence at a significantly earlier age, they were more likely to have experienced a change in caregiver during their childhood, been placed in a children's home and were less likely to be living with a family member on their 16th birthday. Children admitted to special hospital experience a lot of disruption in their childhood and are extremely high users of multi-agency services as they grow up.
Discussion:
Issues are raised regarding how to provide a developmentally sensitive service for children who require high security care.
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