Who gets admitted? Study of referrals and admissions to an adolescent psychiatry inpatient facility over a 6-month period.

BACKGROUND: Child and adolescent psychiatry services have historically been neglected in Ireland, in terms of resource provision and research. AIM: To describe referral and admission patterns to an adolescent inpatient unit in Ireland.
METHODS: We studied reasons for referral and admission decisions relating to all adolescents referred to St. Joseph's Adolescent Inpatient Unit (AIPU), Dublin in the first 6 months following its establishment in 2009.
RESULTS: Forty-one adolescents were referred during the study period; 46 % were admitted. There was no difference between those admitted and not admitted in terms of gender (two-thirds were female), age (mean age 16.2 years), most common reason for referral (depression, in almost one-in-two) and suicidality (present in one-in-two). Amongst those referred, 46 % were resident in the primary catchment area. While a majority of admissions occurred within 5 days of referral (53 %), a significant minority were not admitted until over 20 days after referral (16 %).
CONCLUSIONS: The demographic and clinical characteristics of adolescents referred and admitted to St. Joseph's AIPU are consistent with national and international patterns. At national level, the opening of additional beds for adolescents (such as St. Joseph's AIPU) has had positive effects on admission patterns; our findings indicate a need to further educate referrers about referral criteria, to optimise benefits derived from these new resources. Future studies could examine the potential roles of intensive support services in the community to further maximise use of scarce resources for this patient group.