Hospitalization of Minors in Adult Psychiatric Units and Its Impact on the Quality of Their Care, at the Public Mental Health Establishment of Marne (France)

Introduction: Adolescent mental health is a public health issue. The prevalence of mental disorders was estimated at 13% among French children and adolescents. These individuals are often hospitalized in adult psychiatric wards, despite documented inadequacies. The lack of specialized units exposes this population to poorly adapted care, both clinically and institutionally. The objective of this study was to analyze the conditions of hospitalization of minors in adult wards and to assess the relevance of establishing a specific unit. Methods: This was a twelve-month cross-sectional study (May 2024-April 2025) conducted within the Marne Public Mental Health Institution. The sample consisted of healthcare professionals and the minors they treated in adult units. A novel, anonymous, and self-administered questionnaire collected clinical, organizational, and subjective data related to care modalities, the achievement of therapeutic goals, and professional experience. The analyses were descriptive and thematic, grouping recurring response categories. Data concerning the adolescents were therefore collected from the caregivers interviewed. Results: Our study population consisted of 8 adolescents and 25 caregivers. The minors were between 16 and 18 years old. There were 5 girls and 3 boys, with a female-to-male ratio of 1.67. 62.5% of them (n = 5) lived with their parents, while the others came from residential care facilities. Hospitalizations were exclusively involuntary. The main reasons for hospitalization were severe depressive states (45.5%) and anxiety disorders with suicidal behavior (35.7%). The caregivers were psychiatrists (16%), registered nurses (80%), and nursing assistants (4%). The stays, often prolonged and sometimes repeated, were largely considered unbeneficial. Medication was perceived as largely ineffective (68%), with frequent use of isolation and restraint (according 75.2% of caregivers). Coordination with medical and social service partners was considered difficult, and adolescents showed little engagement in their care plan (84%). Conclusion: While the data clinical collection method may be debatable, the results highlight the structural and clinical limitations of hospitalizing minors in adult psychiatry. The inadequacy of the institutional framework and the lack of therapeutic approaches adapted to adolescence contribute to treatment failures and staff distress. The data support the need to develop specific units offering a supportive, transitional environment that respects the developing autonomy