Background: Children and Adolescent Mental Health Services (CAMHS) in Ireland currently face significant challenges to service provision (e.g. high demand, underfunding and insufficient resources). Paediatric patients presenting to the Emergency Department (ED) in acute psychiatric crisis require assessment and may need further evaluation by mental health services within the hospital or community-based Child and Adolescent Mental Health Services (CAMHS).Aims: The purpose of our study is to characterize the mental health admissions to general paediatric wards in a regional, model 4 hospital.Methods: A prospective cohort study was conducted in a regional university-affiliated hospital, to measure numbers and characteristics of children admitted by general paediatrics teams. Detailed data were collected from July 2024 - June 2025.Results: 125 patients (4% of total admissions) were admitted with mental health issues. Mental health admissions accounted for 590 bed days. The average duration of stay was 6 days (range 1 to 31 days). Seasonal variations were identified with an increase in admissions during January and February. The average age of admission was 13 years (range 8 – 15 years), with the youngest 8 years, with a higher proportion of females (63%) compared to males (37%). 98% of admissions were from ED after presentation in acute crisis. 2% of admissions were referred from outpatient presentations. 38% of admissions were due to suicidal ideation, 18% due to deliberate self-harm, 18% due to deliberate overdose, 9% due to low mood, 9% due to aggressive behaviour and 9% due to eating disorder. 78% of patients were already known to the CAMHS and had a past psychiatric or psychological history. 9% had a co-morbid medical diagnosis. 48% of patients were reviewed by CAMHS as an inpatient, the remaining 52% received outpatient follow-up. 30% of patients required significant supervision and support while on the ward (1:1 special)Conclusions: This study characterised the mental health admissions to general paediatric wards. The study identified resource requirements and challenges to provision of appropriate care for mental health admissions.

