The study was funded by the National Institute for Health and Care Research (NIHR) and looked at the impact of being placed in a bed over 50 miles away from home had on young people aged 13-17 who required admission to hospital for psychiatric care.

The paper ‘Experiences and impact of psychiatric inpatient admissions far away from home: a qualitative study with young people, parents/carers and healthcare professionals’ showed results from the study undertaken by members of the Institute of Mental Health, including Dr James Roe, Professor Kapil Sayal, Professor Richard Morriss, Dr Jo Holland and Public Involvement Lead, Kate Horton. Far Away from Home worked alongside young people, their families, mental health professionals and NHS service commissioners (who allocate NHS funding) in the East Midlands and nationally. Whilst collaborating closely with NIHR ARCs based in the East of England, Greater Manchester, Oxford and Thames Valley and West Midlands regions.

Although national policies aim to avoid the types of admissions where young people are not placed in age-appropriate care, such as admitted to adult wards or in locations far from their home, there are limited spaces available. Some families reported feeling under pressure to accept a bed that is offered to them even if it is far away, due to a lack of choice or availability. Significant concerns have been raised about at-distance admissions and it has been described as ‘unacceptable’.

This type of at-distance care can cause practical and financial challenges for families visiting and poses difficulties with maintaining home contact. Young people reported often feeling guilty about travel costs incurred by parents/carers and felt they couldn’t ask for them to visit when they needed their support. This also caused difficulties in working with families, making activities such as parental involvement in family therapy sessions more difficult. Although staff tried to make accommodations at some locations, with longer visiting times for families who had travelled a far distance, it still increased some tensions on wards due to other patients having more frequent visits from families who lived closer. This resulted in further distress to both patients and families, by increasing the risk of isolation and exacerbated feelings of sadness related to separation, leading to poor clinical outcomes.

Despite this, there is a small minority of young people who perceived this type of at-distance admission to be beneficial to their treatment. As it allowed them space from ‘toxic’ or unsupportive relationships and unhealthy environments, whilst reducing their likelihood of engaging in risky or harmful behaviour. In some cases, it removed some of the stigma associated with the possibility of being recognised or seen when out on local leave. The at-distance admission in some cases also gave the patients the feeling of a fresh start and time to reflect on their future by allowed them more independence. While on occasion improving their relationship with parents/carers as the visits enabled quality time together and time to talk more openly.

The paper concluded that policymakers should consider improving the provision of support for families of young people who are admitted far away from home, to reduce the distress and uncertainty. This should also include additional funding and improvements to publicly accessible information about at distance-care.

To read the study findings in full, please visit BMJ Mental Health

 Watch the animated video below that also summarises the study findings