Young people admitted on a Form 1 to a general hospital: A worrisome trend

To assess and analyze the significance of the increase in the number of paediatric psychiatric admissions under a Form 1 (involuntary admission) to the regional paediatric unit of a general hospital.

The authors retrospectively reviewed the charts of all child psychiatric admissions to the paediatric ward over the years 1998 to 2003. The specific data obtained was that of discharge diagnosis, age and sex of patient, application of Form 1 and transfer to a psychiatric facility.

BROAD DIAGNOSTIC CATEGORIES INCLUDED: mood disorder with and without suicidal behaviour, suicidal behaviour, psychosis, mood disorder with psychosis, anxiety disorder, eating disorder, behaviour disorder, personality disturbance, substance abuse, situational crisis and psychogenic disorder. Yearly admissions to the unit ranged from 25 per year to 45 per year over the five years studied. In the last three years, the rate of Form 1 application increased from one in 1999 to 2000 to 11 in 2002 to 2003 (a 10 fold increase).

Possible reasons for this dramatic increase were identified and may be relevant to other nonpsychiatric centres dealing with children.