Children as young as 9 have been sent to a psychiatric hospital some 2,500 miles away for clinical assessments.

A spokeswoman for the University of Utah’s Neuropsychiatric Institute confirmed the hospital had examined 29 of the island’s minors in the past seven years.

She added: “The last patient from Bermuda who was admitted to UNI was discharged last summer.

“UNI is one of the leading psychiatric hospitals in the United States.

“University of Utah Health is ranked as the best hospital in the state and one of the top academic medical centres in the country.

“The expert and compassionate care of our patients is our foremost priority and the children entrusted into our care by Bermuda’s Department of Child and Family Services system receive world-class quality care at our facility.”

The spokeswoman said children aged between 9 and 18 were treated as inpatients from 2013 to 2019.

She explained: “Children are brought to UNI by a Bermuda Department of Child and Family Services representative, where they are given an in-depth clinical assessment by our team of paediatric mental health experts.

“The children stay for a period of time ranging from one week to several months.

“Once the assessment is complete, the children return to Bermuda with a DCFS escort.”

The UNI spokeswoman said: “The evaluation consists of providing accurate diagnoses, treatment plans, follow-up care plans and life skills for managing symptoms.”

She added that medical records and other documentation that showed a child was in the care of DCFS were required by the hospital to confirm consent for evaluations.

She said that children who needed long-term or additional care could be referred to facilities “across the United States”.

The spokeswoman added: “Participating and supporting patients and/or guardians in discharge planning and placement is an expectation of our treatment team.

“However, guardians are responsible for which programme they select upon discharge from our inpatient facility.”

Kim Wilson, the Minister of Health, said during a Budget debate in the House of Assembly in March that the psychoeducational committee used an overseas agency that specialised in “clinical and comprehensive assessments” in the best interests of children.

Ms Wilson, speaking on behalf of Kathy Lynn Simmons, the Attorney-General and legal affairs minister, who sits in the Senate, said: “The implementation of such an assessment is utilised to assist the Department of Child and Family Services in obtaining a clear and comprehensive understanding of the needs of the referred psycho-ed clients without an identified diagnosis or those that did not engage at all with local service providers.

“The comprehensive overseas assessment assisted in the development of a dynamic, individualised treatment plan that has facilitated the most appropriate match of local community resources or an overseas therapeutic placement that will meet the client’s specific need.

“All children and parents involved in the psychoeducational programme are informed of all aspects of the programme before being placed.

“The court also speaks with the child and confirms with the parents that they fully understand what is involved, the location of the programme, as well as the expected length of stay.”

Ms Wilson said six children in the psychoeducational programme were approved for evaluation at UNI in 2018-19.

She told the House: “The comprehensive assessment and treatment programme at the University Neuropsychiatric Institute, located in Utah, offered our clients a four to six-week comprehensive clinical evaluation in a safe and secure environment.

“The multidisciplinary treatment team assessed psychiatric and medical conditions, provided behavioural and educational assessments, psychological testing, therapy, and when necessary, addressed chemical dependency issues.

“The programme included psychiatric evaluations provided by board-certified child and adolescent psychiatrists with diagnostic expertise in major depression, bipolar, schizophrenia, ADHD, reactive attachment, autistic spectrum disorders, and substance abuse.

“The CAT programme conducted full psychological and neuropsychological testing and therapy provided by PhD psychologists.

“Most importantly, CAT utilised a collaborative approach constructed by a complete multidisciplinary team consisting of child psychiatrists, paediatricians, psychologists, nurses, licensed clinical social workers, recreational therapists, art therapists, music therapists and education specialists.”

Ms Wilson said that two of the children were recommended for placement in an overseas institution for treatment.

She said that a report was provided to the DCFS when patients were discharged and the department was provided with “options of programmes that provide the care required to meet the needs of each child”.

Ms Wilson added: “As a part of the review process, every programme is reviewed both administratively as well as with a site visit, and they must be accredited by an organisation approved by the department, be approved by the Department of Homeland Security to admit international students, and have family therapy as a part of their programme.

“Each programme must have weekly contact with the psycho-ed co-ordinator and provide a monthly report of the progress or lack thereof of the child placed with them.

“Case reviews are conducted on a quarterly basis and any changes to treatment plans are made at that time.”

She said that all children overseas were seen every six months by a member of the psychoeducational team and a “once-a-year minimum one-on-one meeting with the director” was also arranged.