Playing the Admission Game: Young People and Their Parents Negotiating Access or Discharge to Adolescent Inpatient Mental Health Services

Abstract

Background

Only children and young people with the highest need for mental health care or support are admitted to an inpatient setting. There has been a recent shift in emphasis with the aim of inpatient care being short and focussed, care is transferred back to the community on discharge. Little is known about what young people and their parents understand about admission and discharge criteria to these inpatient facilities.

Purpose

This exploratory study aimed to explore the perspectives of young people (aged 18–25) and parents of young people regarding the reasons for their past admissions (or nonadmission) to inpatient child and adolescent mental health services (CAMHS), including beliefs concerning the reasons for subsequent discharge.

Methodology

Data were conducted in various ways according to participant preference either in person telephone or written interview. Participants were young people (n = 5) or parents of young people (n = 5). Thematic analysis was used to identify emerging themes collaboratively.

Results

Based on the three themes that were identified: power control and choice, seeking knowledge and taking control, and conflicting notions of recovery and health we found that young people and their patents were engaged in a complex interaction in which they played the admission game; negotiating admission or discharge through behaviors and counterbalancing risks and benefits.

Conclusion

Understanding the complexity of this interaction may help professionals, including nurses to support patients and their families during the admission, care planning or discharge process and to recognize risks to prevent them escalating.