Mental Health in Deaf Children

The most recent study of mental health in deaf children in England showed that 26% in a sample of 144 signing deaf children and young people not currently accessing child mental health services had a probable mental health problem and 57% had a possible mental health problem.

Modern illness or a thing of the past? Surveillance study of childhood/adolescent Sydenham’s chorea in the UK and the Republic of Ireland

Sydenham's chorea is a rare condition that can have a severe impact on children and families. Tamsin discusses her and her teams research so far, explaining why it is important for clinicians working in child mental health services to report any suspected cases.

Evaluation of a diagnostic ADHD pathway in a community child mental health service in South London

Purpose Clinicians working in UK child mental health services are faced with several challenges in providing accurate assessment and diagnosis of attention deficit hyperactivity disorder (ADHD). Within the South London & Maudsley (SLaM) NHS Trust, community Child & Adolescent Mental Health Services (CAMHS) are developing structured pathways for assessing and diagnosing ADHD in young people. To date, these pathways have not been formally evaluated. The main aims of this evaluation are to evaluate all ADHD referrals made to the service in an 18-month period, including the number of completed assessments and proportion of children diagnosed with ADHD; and investigate adherence to the National Institute for Clinical Excellence (NICE) guideline for diagnosing ADHD in children and young people. Design/methodology/approach Retrospective data analysis was performed using service databases and electronic patient records. Adherence to the clinical guideline was measured using the NICE data collection tool for diagnosing ADHD in children and young people. All completed ADHD assessments were compared to four key recommendation points in the guideline. Findings Within the time frame, 146 children aged 4-17 years were referred and accepted for an ADHD assessment. Of these, 92 families opted in and were seen for an initial appointment. In total, 36 ADHD assessments were completed, of which 19 children received a diagnosis of ADHD and 17 did not. Aside from structured recording of ADHD symptoms based on ICD-10 criteria (69%) and reporting of functional impairment (75%), adherence to all guidance points was above 90%. The study also found that although a greater proportion of children referred to the service were male and identified as White, these differences narrowed upon receipt of ADHD diagnosis. Research limitations/implications Relationship to the existing literature is discussed in relation to the assessment process, demographic characteristics and rates of co-occurrence. Practical implications The findings demonstrate that in child mental health services, gold standard practice for diagnosing ADHD should be the adoption of clear, protocol-driven pathways to support appropriate access and treatment for young people and their families. Originality/value This article is unique in that it is, to the best of the authors’ knowledge, the first to describe and report clinician-adherence to a structured pathway for diagnosing ADHD in young people within a community CAMHS service in South London.

Service- and practitioner-level variation in non-consensual dropout from child mental health services

Non-attendance of mental health service appointments is an international problem. In the UK, for example, the estimated cost of non-attendance in child mental health services is over £45 million (US dollar 60.94 million) per annum. The objective of this study was to examine whether there were service- and practitioner-level variation in non-consensual dropout in child mental health services. This was an analysis of routinely collected data. Service-level variation (as services covered different geographic areas) and practitioner-level variation were examined in N = 3622 children (mean age 12.70 years; SD 3.62, 57% female, 50% white or white British) seen by 896 practitioners across 39 services. Overall, 35% of the variation in non-consensual dropout was explained at the service level and 15% at the practitioner level. Children were almost four times more likely to drop out depending on which service they attended (median odds ratio = 3.92) and were two-and-a-half times more likely to drop out depending on which practitioner they saw (median odds ratio = 2.53). These levels of variation were not explained by levels of deprivation in areas covered by services or by children’s demographic and case characteristics. The findings of the present research may suggest that, beyond service-level variation, there is also practitioner-level variation in non-consensual dropout in child mental health services.