A clinical study of 100 new admissions to an adolescent psychiatric inpatient unit in Singapore.

BACKGROUND

Psychiatric inpatient services for children and adolescents in Singapore began in 1982 when Woodbridge Hospital started the Child and Adolescent Inpatient Unit. To date, this is the only unit with specialised facilities and staff in the management of young patients. Admissions were mainly based on a need for custodial management of acute major behavioural disturbances. Patients were discharged for outpatient treatment once these behaviours subsided.

METHODS

This is a retrospective clinical study of 100 consecutive new patients admitted from April 1993 to August 1994.

RESULTS

Majority of admissions (92%) were adolescents above age 12, who were either attending secondary or vocational school. Most came from nuclear families. Forty-eight percent of referrals were intradepartmental. Ten percent were from general hospitals with 16% as self referrals. Psychoses accounted for the diagnosis in 43%, schizophrenia being the main type. Neurosis and adjustment disorders formed the other main diagnoses. All patients received individual and family treatment. Liaison with schools was required in a third of the cases. Sixty-one percent received pharmacological treatment. Ninety-one percent were discharged home after a stay of less than 3 months. Majority returned to school upon discharge from the hospital.

CONCLUSION

The main criteria for admission in this unit, located in an adult psychiatric hospital, is that of custody of young patients with disturbed and unmanageable behaviour. This provides additional stigma for the admissions of young patients with minor psychiatric problems and interferes with comprehensive care including admission required for some adolescents with psychiatric problems.