Davies Virginia
Whittington Hospital, London, UK.
BJPsych Bull. 2022 Feb;46(1):20-26. doi: 10.1192/bjb.2021.1.
The distressing reality that mental healthcare for children and young people in acute trust settings in the UK is woefully underprovided is not news. But with acute trust debts being written off, hospital trusts and commissioners of services have a timely opportunity to address this age- and condition-based discrimination.Delivering a just service for under-18s depends on attitude, resources and adequate knowledge of the tasks involved. This article aims to describe the current landscape, summarise the arguments for better integrating mental healthcare into physical healthcare settings, articulate the tasks involved and the challenges for commissioning and providing, and finally share examples of current service models across the country.Ultimately, commissioning and provider choices will be constrained by resource pressures, but this article aims to underscore why commissioning and providing a portmanteau 'no wrong door' hospital service for children, young people and families is worth the headache of thinking outside old commissioning and provider boxes.
在英国急症信托机构中,儿童和青少年的心理医疗服务严重不足,这一令人苦恼的现实已不是什么新闻。但随着急症信托债务被核销,医院信托机构和服务专员有了一个及时的机会来解决这种基于年龄和病情的歧视问题。为18岁以下人群提供公正的服务取决于态度、资源以及对相关任务的充分了解。本文旨在描述当前的状况,总结将心理医疗更好地融入身体医疗环境的论据,阐明所涉及的任务以及委托和提供服务所面临的挑战,最后分享全国当前服务模式的实例。最终,委托和提供者的选择将受到资源压力的限制,但本文旨在强调为何为儿童、青少年及其家庭委托和提供一种“无错门”综合医院服务,值得跳出旧有的委托和提供者模式去费心思考。