Psychotropic medication prescribing to children and young people mental health inpatient services: An English national study
David Branford, Anne Webster, Marinos Kyriakopoulos, Shermin Imran, Prathiba Chitsabesan, Tina Irani, Teresa Randon, Kirsten Peebles, Rohit ShankarBackground:
Mental disorders frequently begin in childhood or adolescence. Worldwide, psychotropics are commonly prescribed for under-18s to stabilise behaviour, mood or thoughts. Psychotropics could cause long-term effects on children and young people (CYP) health, growth and development. There is a knowledge gap about psychotropic prescribing in CYP mental health inpatient units.
Aims:
To understand and compare psychotropic prescribing patterns in England mental health inpatient units for CYPs and to solicit CYP and their parents’ and carers’ views of it.
Method:
A national Quality Improvement programme authorised by National Health Service (NHS) England invited all English CYP mental health inpatient units to participate. The programme included an anonymous medication census to capture psychotropic prescribing practices of participating units. A further two questionnaires sought views of inpatient CYP and their parent carers on the prescribing. All material was co-produced with patient and clinical stakeholders. Quantitative data were presented descriptively and free text responses thematically analysed.
Results:
Forty-eight providers overseeing 73 units, that is, 79% of all England NHS commissioned units, with 625 CYP inpatients responded. Of these, 545 (87%) were receiving psychotropics, with 354 (57%) prescribed two or more. Pro re nata (PRN) prescribing practice was variable. Questionnaires were completed by 142 CYP and 75 parent carers. Free text response analysis showed seven themes emerge from the CYP questionnaire and 11 from the parent-carer one.
Conclusions:
This is the first English study to systematically explore psychotropic prescribing patterns in CYP mental health inpatient units. The study showed psychotropics are widely prescribed, on a regular and PRN basis.