Explore the vast range of titles available.

Aims: To explore the physical health of YP admitted to adolescent inpatient mental health units and reflect on any differences over the following 6 months. Research Questions: 1. To assess physical health of young people upon admission to adolescent inpatient services (cardiovascular risk factors e.g. BMI, blood pressure, blood glucose and lipids). 2. To assess current lifestyle behaviours of young people upon admission to adolescent inpatient wards (e.g. physical activity, diet, smoking rates). 3. To assess changes in physical health/lifestyle 3 months and 6 months post-admission. 4. To understand the impact of inpatient care environment on lifestyle behaviours and physical health of adolescents admitted to inpatient units. 5. To understand the experiences and beliefs about physical health in adolescents admitted to inpatient units. 6. To establish the feasibility of monitoring physical health in a cohort of young people upon admission to an adolescent inpatient unit. Methods: We aimed to recruit young people aged 14+ from each participating site within 6 weeks of admission to the unit. The young person needed to be able to give informed consent and be well enough to take part (severe anorexia/eating disorder excluded). Physical and mental health assessments were completed by a researcher in conjunction with the clinical team. Assessments completed at three time points: Baseline on admission; 3 months post admission; 6 months post admission. Participants given £10 voucher at each timepoint as a thank you (total £30). Measures collected included: Demographic information, e.g. age, gender, ethnicity, education, diagnoses, previous admissions, medication, length of admission; Physical Health Outcomes, e.g. BMI (centiles), BP, routinely collected blood tests (random glucose, lipids, etc), ECG; Behavioural Outcomes, e.g. physical activity levels, smoking status, diet, physical fitness (six-minute walk & questionnaire), substance use, comorbid physical health disorders and concurrent treatments; Mental Health Outcomes, e.g. Health of the Nation Outcome Scales for Children and Adolescents (HONOSCA), World Health Organization Wellbeing Index (WHO-WI). Results: Physical health outcome (Weight): Baseline – 64.5. 3 months – 67.7. 6 months – 69.3. Behavioural outcome: Low levels of physical activity (average 20 mins sport and 1 hour walking per day); High levels of sedentary behaviour; Most common substances used were alcohol (n=11, 44%), tobacco (n=10, 40%) and cannabis (n=6, 25%); Most YP self-reported average fitness levels; Consumed on average 1.8 meals per day (ranged from 1–5). HONOSCA outcome: 80% lack of concentration (68% severe); 75% self-harmed; 56% difficulties with relationships at home (30% severe); 88% anxious or low mood (44% severe); 64% impairments with educational ability; 64% stopped attending education. Qualitative interviews (thematic analysis): Outcomes on Young peoples knowledge, Autonomy, environment, sources of support, independence and facilitators. Conclusion: Young people on CAMHS inpatient units have multiple factors affecting their physical health; Already showing some signs of compromised physical health, likely to worsen; Observed lots of challenges with transitory care and barriers to following people up after discharge; Future work will focus on breaking down some of the barriers experienced to living well; Working on refining a physical health intervention.

AimsTo ensure that there is a clear rationale for commencing service users on psychotropic medications.To ensure that the prescription of psychotropic medications is evidence-based and that they are in line with the Trusts and NICE guidelines.Ensure that psychotropic medications are regularly reviewed by the managing team.To ensure that information about medications is adequately shared with patients and carers.To ensure that service users are well-monitored for side effects.MethodsA 2-week retrospective audit on Phoenix ward.Clinical information from all the current service users on psychotropic medication was reviewed.The clinical information was collated from all 8 service users’ medication cards, ward round documents, MDT reviews, and electronic notes (PARIS), and these were analyzed by the inpatient specialty registrar.Results1. We attained a 100% mark in some areas of our prescribing such as indicating the rationale, the maximum dose for medication, and also prescribing within BNF limits.2. We however could not evidence proper information sharing with patients (only 40% documented).3. We could not evidence sufficient information sharing with carers (only 20% documented).4. PRN medication was mostly prescribed as a range rather than a clear dose, which gave rise to subjective dispensing bias.5. Side effect monitoring was documented for 85% of patients, meanwhile, the standard for this is 100%.ConclusionClinicians are to ensure that medication information is always shared with service users, and their carers, and this is documented.Clinicians are to also ensure that PRN medications are prescribed as a single dose rather than as a dose range.Ward staff are to ensure that they are monitoring side effects and documenting these clearly on electronic notes and ward round documents.The MDT is to ensure that all regular and PRN medications are reviewed regularly during ward rounds.Present this audit, share relevant findings with the clinical team, and monitor the implementation of the action plans by doing a reaudit in 6 months.