An article appeared on The Times on September 27 entitled Five Minors In Adult Wards. It was shocking to read about the utter and blatant violation of children’s rights.
The item was about five minors at Mount Carmel Hospital who were being kept in adult wards because they were described as “too disturbed” to remain in the Young People’s Unit. The reason given is poor of substance and that is because there is no plausible explanation allowing minors to be kept in adult wards. Minors and adults are segregated because it is harmful for minors to be kept with adults and this for obvious reasons. It is not in the best interest of children for them to be kept with adults.
A further reason given, which is outright irrational, was that the fact that minors are kept in “more secure acute adult wards” is a “therapeutic message that such challenging behaviour is not tolerated in the YPU”.
First of all, the word “therapeutic” is incorrectly used here. What therapeutic benefit is there in keeping minors in acute adult wards? I fail to see any benefits. If there are any positives (which there aren’t), the negatives far outweigh them! And what’s more, it seems that they are sent to the acute adult wards as a sort of “punishment” to show them that their “challenging” behaviour is not tolerated. Oh, so it is perfectly alright to breach children’s rights by putting them in an adults’ ward as long as they learn a lesson not to have such challenging behaviour. It is admitted by the government spokesman quoted in the item that these adult wards are “not particularly child friendly”, so, again, why are they put there?
The sad irony of it all is that, “Sometimes, youngsters no longer need to be in hospital but no suitable long-term residential or foster placement can be found”. The system itself is letting these minors down, so how can we expect the minors themselves to make any progress?
Article 3 of the United Nations Convention on the Rights of the Child says: “States parties undertake to ensure the child such protection and care as is necessary for his or her well-being.” It is clear that, in this situation, such is not being done.
Article 24 of the same convention goes even further: “States parties recognise the right of the child to the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health. States parties shall strive to ensure that no child is deprived of his or her right of access to such health-care services.”
What is highest attainable standard of health? It certainly does not mean that minors are to be kept in adult wards. In essence, when minors are kept in adult wards they are being deprived of the highest attainable health-care service because of the very environment in such wards.
The European Association for Children in Hospital (EACH) charter states in article 1: “Children shall be admitted to hospital only if the care they require cannot be equally well provided at home or on a day basis.”
The fact that there are instances where minors do not need to be in hospital but because there is no other suitable arrangement they are kept there is undermining the children’s best interests. Again, here the system is sadly failing them.
In addition, article 6 of the EACH charter lays down that “Children shall be cared for together with children who have the same developmental needs and shall not be admitted to adult wards’. It seems that in our case it is “a therapeutic lesson” for minors with challenging behaviour to be kept there even though this goes directly against the children’s best interests as stated in the EACH charter.
It is a proven fact that minors with mental health problems and who are kept in adult wards have difficulty adjusting to facilities that are designed primarily for adults such as adult wards (Office of the Children’s Commissioner, 2007 as quoted in Steven Pryjmachuk (ed), Mental Health Nursing: An Evidence Based Introduction, SAGE Publishers, 2011, p. 335).
Minors should be treated and taken care of in a suitable environment adequate for their age. Therefore, it is no justification for minors to be kept in adult wards because their behaviour is too “challenging”.
They should still be taken care of in a children’s environment. In fact, adult wards are not “therapeutic” at all for minors and most minors placed in adult wards suffer a traumatic experience that may lead to permanent damage. The then chairman of the United Kingdom’s Mental Health Alliance, Andy Bell, said that “Vulnerable children who need care and treatment (and, thus, are placed in psychiatric adult wards) often leave in a worse condition than when they arrived” (MPs Urged To Stop Children Being Placed On Adult Mental Health Wards, September 8, 2007, Mail Online).
The fact that children should not be kept in adult wards is of significant importance because it goes against their inherent health rights, precisely because it is not in their best interests to be kept in such wards.
Dr Mangion is a lawyer and a published author with a special interest in family and child law.