Children and Young People
| Author | Michael Butler |
| Pages | 259-268 |
Part Eight
Other Aspects of Mental Health Law
Chapter 24
Children and Young People
24.1 INTRODUCTION
This chapter focusses on the special considerations which apply in respect of children or young people who may require treatment for mental disorder. In this respect, ‘children’ means those who are under the age of 16, and young people means those who are either 16 or 17 years old. Attention is paid in particular to the various legal frameworks within which decision-making around hospital admission and treatment must take place.
24.2 CHILDREN AND ADOLESCENT MENTAL HEALTH SERVICES
Mental health service provision for the under 18s is a specialist area and the 1983 Code, therefore, suggests (para 36.75) that, ‘those responsible for the care and treatment of children and young people should be child specialists’. This invariably means health professionals from Child and Adolescent Mental Health Services (CAMHS), the multi-disciplinary service common to all localities which organises and provides the full range of mental health services for children and young people, from primary care, to specialist community-based care, through to specialist in-patient units.
Where any assessment is being carried out with a view to detaining a child or young person under the MHA 1983, the AMHP or one of the two RMPs involved should be a CAMHS specialist. If none is available, one should be consulted as soon as possible after the assessment (1983 Code, para 36.20).
One particular area of CAMHS provision is that of specialist in-patient units for children and young people, an aspect of the service which caters for a need recognised by the MHA 1983. Section 131A(2) stipulates that for any under 18 year old admitted to hospital, whether or not detained, ‘the managers of the
262 A Practitioner’s Guide to Mental Health Law
hospital shall ensure that the patient’s environment in the hospital is suitable having regard to his age (subject to his needs)’. According to the 1983 Code (para 36.68), being cared for in an age suitable environment in accordance with section 131A means:
• appropriate physical facilities;
• staff with the right training, skills and knowledge to understand and address their specific needs as children and young people;
• a hospital routine that will allow their personal, social and educational development to continue as normally as possible; and
• equal access to educational opportunities as their peers, in so far as that is consistent with their ability to make use of them, considering their mental state.
In practice, this should mean being looked after on a dedicated children or young persons’ ward, and it will only be in exceptional circumstances that a child or young person should be accommodated on an adult ward. Exceptional circumstances might include, for example, a short-term emergency measure where safety considerations take precedence, a patient expressing a reasonable preference for being nursed on an adult ward, or a patient being just short of his 18th birthday and it being thought disruptive to the patient’s care to have a short-term placement on a CAMHS unit before transfer to an adult unit.
The 1983 Code suggests (para 36.70) that in the exceptional circumstances where a young patient is not accommodated in a CAMHS unit ‘then discrete accommodation in an adult ward, with facilities, security and staffing appropriate to the needs of the child, might provide the most satisfactory solution’.
24.3 LEGAL AUTHORITY TO ADMIT AND/OR TREAT A CHILD OR YOUNG PERSON
There are a variety of possible sources of authority for admitting to hospital and treating a child or young person. In the first instance, authority may of course come from the child or young person himself. Otherwise, in certain circumstances, it may come from the person with parental responsibility for the child or young person. Alternatively, use may be made of the MHA 1983 or of the MCA 2005, and even, occasionally...
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