The Staffing of Inpatient Child and Adolescent Mental Health Services

There is a need for more accurate information regarding the staffing of Child and Adolescent Psychiatric inpatient units. This is both to facilitate clinical governance and to allow planning and focused further development of these services.

Postal surveys were sent to all units in England and Wales.

Seventy-three percent (n = 1060) of the 1460 staff employed by the units were nurses; 43% of nurses were unqualified. On average there was one consultant psychiatrist for every 25 patients. Only 12% of nurses working on a 'census' day held a specialist qualification in nursing children. The use of agency and bank staff was higher in independent sector units than in NHS units (37% vs 10% of all nurses who worked a shift on the census day).

Some child and adolescent inpatient units are not staffed by a multi-disciplinary team. There is evidence of problems of recruitment and retention of nurses.