Children's Understanding of a Psychiatric In-patient Admission

Abstract

Children (aged 8-13) admitted to an in-patient unit, were interviewed shortly after admission and before discharge, to explore how they made sense of the admission. The interviews were transcribed, coded and analysed to identify emergent themes. The findings suggest that children understood the reason for admission to relate to gaining control over 'out of control' emotions and behaviours that they perceived, in many cases, as leading to rejection by family, school or peers. At admission, the children expected to be passive recipients of 'help', with staff 'taking charge'. They valued the experience of containment provided by the unit. By the end of admission, children's conceptualization of their role in 'getting better' had shifted to incorporate an increasing sense of their own agency. Being taught strategies for anger-or anxiety-management was particularly valued by the children as helping them meet their objectives. However, despite the relevance of the children's ideas for treatment goals, children perceived themselves as excluded from goal setting. Ways in which services can enhance children's participation in decisions about treatment are discussed.