Referral to an Acute Child and Adolescent Inpatient Unit: The Experiences and Views of Community Mental Health Referrers

Admission to an acute mental health inpatient unit is a significant event for a young person. The interface between inpatient and community teams negotiating the admission and later discharge can be fraught. To understand how to improve the transition between inpatient and community care, we interviewed 48 community clinicians about their experiences of engaging with an acute child and adolescent mental health inpatient unit. Through thematic analysis, we identified management of risk was a central issue. Participants wanted more time in hospital, and more communication and collaboration. They expressed appreciation, but some gave intense descriptions of dissatisfaction. The analysis suggests avenues to improve communication and experience, recognizing the (felt) power differential between inpatient and referring community clinicians. Managing the power dynamics requires inpatient clinicians to use active inquiry to bring forward community clinicians’ views and be mindful of the risk of community clinicians experiencing communication as criticism.