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People say the treatment in England is much better, and it is, unless you are under 18.

MH treatment is underfunded in England (and this has recently been written into commissioning contracts) and it is worse for children and young people.

In patient beds for children are limited. A child who needs an in patient bed may have to travel hundreds of miles to get that bed. They may even need to travel to a different country.

A child in the south of England may not have a bed available anywhere in England and might need to go to Scotland for a bed.

Apart from the obvious cost of distance and the distress of being so far from home (although getting distance from an abusive home can be useful) that child is now under a different legal system. Thus, the rules for detaining them against their will; force feeding; forced medication; etc etc are all slightly different.




I used to work in an outpatient neuro department that had a large paediatric patient population. One of the paediatric neurologists there had done her training at a famous children's hospital in London (GOSH) and said that it was a fantastic place to train in, but terrible for the outcome of the children.

Where we were in Melbourne, we had four paediatric neurologists for a catchment area of about 400k give or take. GOSH had six neurologists for a catchment area of 2 million. "By the time the kids in London got to see us, the symptoms were so florid and easy to see. Great for training, not so great for outcomes".

She did her training in the 90s, so it may have since changed. It's also a story about neurologists, not psychiatrists, but I imagine it wouldn't be that much different.




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