BACKGROUND There are significant clinical, policy and societal concerns about the impact on young people (YP), from admission to psychiatric wards far from home. However, research evidence is scarce. AIMS To investigate the impact of at-distance admissions to general adolescent units, from the perspectives of YP, parents/carers and healthcare professionals (HCPs) including service commissioners, to inform clinical practice, service development and policy. METHOD Semistructured interviews with purposive samples of YP aged 13-17 years (n=28) and parents/carers (n=19) across five large regions in England, and a national sample of HCPs (n=51), were analysed using a framework approach. RESULTS There was considerable agreement between YP, parents/carers and HCPs on the challenges of at-distance admissions. YP and parents/carers had limited or no involvement in decision-making processes around admission and highlighted a lack of available information about individual units. Being far from home posed challenges with maintaining home contact and practical/financial challenges for families visiting. HCPs struggled with ensuring continuity of care, particularly around maintaining access to local clinical teams and educational support. However, some YP perceived separation from their local environment as beneficial because it removed them from unhelpful environments. At-distance admissions provided respite for some families struggling to support their child. CONCLUSIONS At-distance admissions lead to additional distress, uncertainty, compromised continuity of care and educational, financial and other practical difficulties, some of which could be better mitigated. For a minority, there are some benefits from such admissions. CLINICAL IMPLICATIONS Standardised online information, accessible prior to admission, is needed for all Child and Adolescent Mental Health Services units. Additional practical and financial burden placed on families needs greater recognition and consideration of potential sources of support. Policy changes should incorporate findings that at-distance or adult ward admissions may be preferable in certain circumstances.

中文翻译：

---

远离家乡的精神病住院患者的经历和影响：一项针对年轻人、父母/照顾者和医疗保健专业人员的定性研究。


背景 人们对从入院到远离家乡的精神科病房对年轻人（YP）的影响存在重大的临床、政策和社会担忧。然而，研究证据却很少。目的 从 YP、家长/照顾者和包括服务专员在内的医疗保健专业人员 (HCP) 的角度，调查远程入院对一般青少年单位的影响，为临床实践、服务发展和政策提供信息。方法 对英格兰五个大地区 13-17 岁 YP (n=28) 和父母/照顾者 (n=19) 的有目的样本以及全国 HCP 样本 (n=51) 进行半结构化访谈，使用框架方法。结果 YP、家长/照顾者和 HCP 之间就远程入院的挑战达成了相当大的共识。 YP 和家长/照顾者对入学决策过程的参与有限或没有参与，并强调缺乏有关各个单位的可用信息。远离家乡给保持家庭联系带来了挑战，也给来访的家庭带来了实际/财务方面的挑战。医护人员在确保护理的连续性方面遇到了困难，特别是在维持与当地临床团队的联系和教育支持方面。然而，一些 YP 认为脱离当地环境是有益的，因为这使他们远离了无益的环境。远程入学为一些难以养活孩子的家庭提供了喘息的机会。结论 远程入院会导致额外的痛苦、不确定性、护理连续性受损以及教育、财务和其他实际困难，其中一些问题可以更好地缓解。对于少数人来说，这样的录取有一些好处。 临床意义 所有儿童和青少年心理健康服务单位都需要在入院前获取标准化的在线信息。给家庭带来的额外实际和经济负担需要更多地认识和考虑潜在的支持来源。政策变化应纳入以下发现：在某些情况下，远程或成人病房入院可能更可取。