Autistic spectrum disorder without intellectual impairment in adult mental health services – fostering new perspectives and enhancing existing services

2018 ◽  
pp. 1-7
Author(s):  
N. Crowley ◽  
H. O’Connell ◽  
M. Gervin
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Autistic Spectrum Disorder ◽  
Mental Health Problems ◽  
Health Problems ◽  
Spectrum Disorder ◽  
Intellectual Impairment ◽  
Autistic Spectrum ◽  
Adult Mental Health

Autistic spectrum disorder (ASD) is a neuro-developmental disability with multi-systemic impacts. Individuals with ASD without intellectual impairment (DSM-V) or Aspergers (DSM-IV) are often particularly vulnerable to mental health problems such as anxiety disorders including social phobia and generalised anxiety disorder, depressive disorders and psychosis. Adults with ASD without intellectual impairment suffer higher rates of physical and psychiatric morbidity, display a poorer ability to engage with treatment and have a lower chance of recovery compared with the general population. It is widely acknowledged that adults with suspected ASD without intellectual impairment and co-morbid mental health problems are often not best supported through adult mental health services and often require more tailored supports. This review seeks to (a) increase awareness in the area of undiagnosed cases of ASD without intellectual impairment in adult mental health settings and (b) highlights the importance of identifying this population more efficiently by referring to best practice guidelines. The value of future research to examine the benefit of having a team of specialist staff within adult mental health teams who have received ASD training and who are supported to work with the ‘core difficulties’ of ASD is discussed and a model for the same is proposed. It is proposed that a specialist team could form a ‘hub’ for the development of expertise in ASD, which when adequately resourced and funded could reach across an entire region, offering consultancy and diagnostic assessments and interventions.

scholarly journals Adult mental health services and the collaboration with child protection services

2016 ◽  
Vol 5 (5) ◽  
pp. 72 ◽  
Author(s):  
Camilla Lauritzen ◽  
Charlotte Reedtz
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Professionals ◽  
Child Protection ◽  
Mental Health Problems ◽  
Health Problems ◽  
Child Protection Services ◽  
Adult Mental Health ◽  
Service Collaboration

Parental mental illness may increase the likelihood of neglect and abuse, and is also a potent risk factor in terms of offspring developing mental health problems themselves. Collaboration between the adult mental health services (AMHS) and the child protection services (CPS) has the potential of reducing risk for the children, by using family supporting interventions and making help available at an earlier stage. The aim of this study was to explore the collaboration between the CPS and the AMHS in terms of routines, attitudes and knowledge. Data was gathered using electronic survey questionnaires. Several barriers to inter-service collaboration were identified in this study. Even though adult mental health professionals were positive towards the CPS, they were reluctant to refer cases of concern. They also lacked knowledge about the CPS. Conclusion: The results indicate that there is an unresolved potential for inter-service collaboration involving the children of patients with mental health problems.

scholarly journals Experience of transfer from child to adult mental health services of young people with autism spectrum disorder

BJPsych Open ◽  
2020 ◽  
Vol 6 (4) ◽  
Author(s):  
Hannah Merrick ◽  
Chris King ◽  
Helen McConachie ◽  
Jeremy R. Parr ◽  
Ann Le Couteur
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorder ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Mental Health Problems ◽  
Unmet Need ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Adult Mental Health

Background Transition from child-centred to adult mental health services has been reported as challenging for young people. It can be especially difficult for young people with autism spectrum disorder (ASD) as they manage the challenges of adolescence and navigate leaving child and adolescent mental health services (CAMHS). Aims This study examines the predictors of transfer to adult mental health services, and using a qualitative analysis, explores the young people’s experiences of transition. Method A UK sample of 118 young people aged 14–21 years, with ASD and additional mental health problems, recruited from four National Health Service trusts were followed up every 12 months over 3 years, as they were discharged from CAMHS. Measures of mental health and rich additional contextual information (clinical, family, social, educational) were used to capture their experiences. Regression and framework analyses were used. Results Regression analysis showed having an attention-deficit hyperactivity disorder diagnosis and taking medication were predictors of transfer from child to adult mental health services. Several features of young people's transition experience were found to be associated with positive outcomes and ongoing problems, including family factors, education transitions and levels of engagement with services. Conclusions The findings show the importance of monitoring and identifying those young people that might be particularly at risk of negative outcomes and crisis presentations. Although some young people were able to successfully manage their mental health following discharge from CAMHS, others reported levels of unmet need and negative experiences of transition.

scholarly journals Transition from child and adolescent mental health services to adult mental health services: children in care and adopted children

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S168-S169
Author(s):  
Paula Adamopoulos ◽  
Rani Samuel
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Problems ◽  
Child And Adolescent ◽  
Health Problems ◽  
Adopted Children ◽  
Adult Mental Health ◽  
Therapeutic Engagement ◽  
Children In Care

AimsMental health transition-related disengagement is a major public health problem. This study aims to review children in care (CIC) and adopted children's transitions from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS). This study aims to illustrate the often overlooked complexities that are associated with this population's transitions.It is hypothesised that this population is at an increased risk for disengagement post-transition. Such is hypothesised as a result of the population's increased prevalence of complex mental health problems, neuro-developmental needs and developmental trauma. This population would benefit from a transition (optimal), as opposed to a transfer of care (suboptimal).MethodThis retrospective case study included young people from Lewisham CAMHS's team for looked after and adopted children. Optimal transition was evaluated using four criteria: continuity of care, parallel care, a transition planning meeting and information transfer.ResultA total of 34 cases (male = 14, female = 20) were included, 88% of which were CIC (12% were adopted children). 85% of the cases included reports of at least one form of abuse and/or neglect. 59% of the cases were categorised as having more than one diagnostic group of mental health problems.30% (n = 11) of the cases were discharged and were not recorded to have re-engaged with Lewisham AMHS. 12% of the cases had an outcome as 'unknown' due to miscellaneous reasons.Only 18% (n = 6) of the cases had an ‘optimal’ transition. 18% (n = 6) had a suboptimal transfer and of those cases, 66% (n = 4) did not engage with AMHS beyond three months post-transfer. 21% (n = 7) were re-referred to Lewisham AMHS after being discharged from CAMHS. None of the re-referred cases engaged with AMHS post-referral.ConclusionIn conclusion, these findings demonstrate that this population is highly complex and can often experience suboptimal transitions from CAMHS to AMHS. Anything less than an 'optimal' transition yields a low ratel of therapeutic engagement. Recommendations for clinical practice includes an extended period of ‘overlap time’ between CAMHS to AMHS for CIC and adopted children. This overlap period will enable mental health practitioners to provide more informed and consistent support that incorporates the needs of CIC and adopted children. Such a provision will enhance therapeutic engagement and subsequently, promote better outcomes for CIC and adopted children. These findings have important resource implications for both CAMHS and AMHS teams.

“Walking wounded or wounded healer?” Does personal experience of mental health problems help or hinder mental health practice? A review of the literature

2014 ◽  
Vol 18 (1) ◽  
pp. 35-44 ◽  
Author(s):  
Catherine Conchar ◽  
Julie Repper
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Peer Support ◽  
Personal Experience ◽  
Mental Health Problems ◽  
Health Problems ◽  
Review Of The Literature ◽  
Wounded Healer ◽  
Content Type

Purpose – A systematic review of the literature on “wounded healers” was undertaken to identify, define and interpret the term and its application within the mental health environment. The paper aims to discuss these issues. Design/methodology/approach – Eight key medical/social sciences databases were interrogated. In total, 835 papers were identified in the systematic database search and abstracts were obtained for each to determine whether they met the inclusion criteria. In total, 237 sources were retrieved for critical reading, to assess relevance and value to the review, and 125 documents were subsequently included. Through thematic analysis a number of themes and sub themes were identified Findings – The archetypal image of the wounded healer originates in ancient mythology and crosses many cultures. There are many interpretations and applications of the belief that having healed their own wounds a person is in a better position to heal others, however, the evidence to support this is not so robust. Of more direct relevance to contemporary practice are reports of supporting staff with mental health problems to make a contribution to mental health services, most recently through the employment of peer support workers. Originality/value – As peer support workers are increasingly being employed in mental health services, it is helpful to consider the many existing staff who bring personal experience of mental health problems. This paper explores the evidence that their lived experience makes a difference to the way that they work and considers their employment support needs.

scholarly journals Digital cognitive behaviour therapy for insomnia (CBTi) for adolescents with mental health problems. Results from a feasibility open trial. (Preprint)

2019 ◽  
Author(s):  
Bethany Cliffe ◽  
Abigail Croker ◽  
Megan Denne ◽  
Jacqueline Smith ◽  
Paul Stallard
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Problems ◽  
Health Problems ◽  
Anxiety And Depression ◽  
Severity Scale ◽  
Sleep Condition ◽  
Condition Indicator ◽  
Insomnia Severity

BACKGROUND Insomnia in adolescents is common, persistent, and associated with poor mental health including anxiety and depression. Insomnia in adolescents attending child mental health services is seldom directly treated and the effects of digital CBTi on the mental health of adolescents with significant mental health problems is unknown. OBJECTIVE This paper reports an open study assessing the feasibility of adding supported online CBT for insomnia to the usual care of young people aged 14-17 years attending specialist child and adolescent mental health services. METHODS Thirty-nine adolescents aged 14-17 attending specialist child and adolescent mental health services with insomnia were assessed and offered digital CBTi. The digital intervention was Sleepio, an evidence based, self-directed, fully automated CBTi that has proven effective in multiple randomized controlled trials with adults. Self-report assessments of sleep (Sleep Condition Indicator, Insomnia Severity Scale, online sleep diaries), anxiety (Revised Child Anxiety and Depression Scale) and depression (Mood and Feelings Questionnaire) were completed at baseline and post-intervention. Post-use interviews assessed satisfaction with digital CBTi. RESULTS Average baseline sleep efficiency was very poor (52.9%) with participants spending an average of 9.6 hrs in bed but only 5.1 hrs asleep. All scored <17 on the Sleep Condition Indicator with 36/39 (92.3%) scoring ≥15 on the Insomnia Severity Scale, suggesting clinical insomnia. 36 (92.3%) scored ≥ 27 on the Mood and Feelings Questionnaire for major depression and 20 (51.3%) had clinically elevated symptoms of anxiety. The majority (76%) were not having any treatment for their insomnia, with the remaining 24% receiving medication. Sleepio was acceptable with 77% (30/39) activating their account and 67% (21/30) completing the program. Statistically significant pre-post improvements were found in weekly diaries of sleep efficiency (p=.005) and sleep quality (p=.001) and on measures of sleep (SCI; p=.001: ISI; p=.001), low mood (MFQ; p=.024) and anxiety (RCADS; p=.015). Satisfaction was high; with 89% finding Sleepio helpful, 94% would recommend it to a friend with 39% expressing a definite preference for a digital intervention. CONCLUSIONS Our study has a number of methodological limitations, particularly the small sample size, absence of a comparison group and follow-up assessment. Nonetheless, our findings are encouraging and suggest that digital CBTi for young people with mental health problems might offer an acceptable and an effective way to improve both sleep and mental health. CLINICALTRIAL N/a

scholarly journals Deployment, Mental Health Problems, Suicidality, and Use of Mental Health Services Among Military Personnel

2016 ◽  
Vol 4 (3) ◽  
pp. 243-250 ◽  
Author(s):  
Carol Chu ◽  
Ian H. Stanley ◽  
Melanie A. Hom ◽  
Ingrid C. Lim ◽  
Thomas E. Joiner
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Military Personnel ◽  
Mental Health Problems ◽  
Health Problems
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