'My teenage daughter is terrified in an adult psychiatric unit'

A mother has said her teenage daughter is "terrified" of the adult men in the secure psychiatric care unit where she is being treated.

Gillian, not her real name, told the BBC her 17-year-old daughter felt sexually vulnerable and unsafe in a mixed unit with eight adult men.

A tribunal heard evidence from her psychiatrist that the unit was an "unsuitable environment".

However, there are no secure in-patient units in Scotland for adolescents.

Health Secretary Jeane Freeman told BBC Scotland she had recognised the national need for secure child and adolescent mental health inpatient facilities in Scotland and a new unit was planned.

Ms Freeman said it was "very rare" for a young person to be put in an adult unit but it was for clinicians to decide where it was safest to put them.

Gillian's daughter has been in an adult Intensive Psychiatric Care Unit (IPCU) in Edinburgh for a week.

IPCUs are designed to look after patients who cannot be managed on open wards due to the level of risk they pose to themselves or others.

She was moved there from a Child and Adolescent Mental Health (CAMH) unit after incidents led her psychiatrist to believe she needed more secure care.

But Gillian said the unit she was placed in was totally unsuitable for a vulnerable young girl.

She said the men looked at her daughter in sexually inappropriate ways and followed her around the unit.

Gillian said she feared for her daughter's safety

Gillian said that on her first visit to the unit there was one man in his 50s flicking his tongue "in a sexually inappropriate manner" and another who was "shouting aggressively".

"I did not feel safe and I was scared and petrified for my daughter," she said.

"I was shaking like a leaf and I felt I was going to be sick."

She said her young daughter was feeling extremely sexually vulnerable and uncomfortable at having to share communal spaces with older men with serious mental health issues.

"My daughter told the tribunal judge she is absolutely terrified and scared men will slash her face," Gillian said.

"She's terrified to even eat with them."

Last year 14 young people were admitted to adult IPCUs, including five under-16s, according to watchdog the Mental Welfare Commission (MWC).

It said adult psychiatric wards were unsuitable places to treat young people with mental health issues because they have to be looked after alongside adults who are themselves very unwell or high risk.

However, Dr Moira Connolly, from the MWC, said the patient should stay closely linked to the staff who had supported them in the CAMH adolescent unit and a care plan should be in place.

Earlier this week, a Mental Health Tribunal decided that a Compulsory Treatment Order for Gillian's daughter was correct but it heard evidence that even her own psychiatrist considered the IPCU an "unsuitable environment".

In the weeks before her admission to the IPCU, Gillian's daughter had been in an adolescent mental health unit.

Gillian said her daughter's generalised anxiety disorder had not been treated and she had entered the first stage of psychosis.

She was not responding to the anti-psychotic medication and she was moved to a different drug.

Although she seemed to respond better, there was an incident in the adolescent unit that led to fears for Gillian's daughter's safety and that of other patients.

The 17-year-old was held in "seclusion" within the adolescent ward, meaning she was not allowed to leave her room and nurses were stationed by her door.

After a number of days she was moved to the intensive psychiatric care unit (IPCU).

Her psychiatrist told the tribunal he had been "very reluctant to admit her to IPCU but it was less restrictive than seclusion".

He said that although the patient had responded well to treatment and change in medication, she was still not well enough to return to the CAMH adolescent ward.

Gillian believes it is "appalling" that there are no intensive psychiatric care units in Scotland to deal with adolescents.

She said she thought her daughter could have been treated at a unit within the CAMH ward, where she could have been placed until her medication had "bedded in".

"There is no adolescent IPCU in the whole of Scotland, it's diabolical," she said.

Scotland has only has three specialist units for in-patient treatment for children and adolescents, with 48 beds.

Health Secretary Jeane Freeman said she understood people's concern and anxiety

Health Secretary Jeane Freeman told BBC Scotland she understood people's concern and anxiety at where adolescent patients were placed.

She said: "We have always said there needs to be an additional provision of secure units for children and adolescents and indeed one is being built in Ayrshire and Arran."

The new national inpatient unit is scheduled to open in 2021.

Ms Freeman added: "We are looking at what more we need to do for child and adolescent mental health across the whole spectrum from counselling to very specialist support."

Prof Alex McMahon, nurse director at NHS Lothian, said he could not comment on individual patient cases.

He said: "In psychiatric services there are occasional circumstances where due to the severity of a patient's illness, they may require a short period of more intensive care and treatment in a more controlled environment.

"Any decision would be taken following clinical assessment, to ensure the continued safety and welfare of the patient and of other patients and staff."

Prof McMahon added that any young person who is moved to an IPCU will have one-to-one intensive nursing at all times and is allocated to single bedroom accommodation.