Services fail young people with learning difficulties and behaviour problems

Current services are failing children and adolescents with
learning difficulties who suffer from additional psychological or
behavioural problems, leading child psychiatrists have claimed,
writes Lauren Revans.

Despite substantial evidence to suggest a much higher prevalence
of mental health and behavioural problems among young people with
learning difficulties than the general child and adolescent
population, services for this client group remain almost
non-existent, a Community Care-sponsored conference in
London was told last week.

Oral, dental, visual, and speech problems in children and
adolescents with learning difficulties are also often over-looked,
they added.

Dr Jeremy Turk, child mental health learning disability service
clinical team leader at St Georges’ Hospital, Tooting, south
London, said: “It is no longer tenable for people to be unaware of
the psychiatric, psychological, and behavioural needs of people
with learning difficulties may have.”

He suggested that child and adult mental health services should
dedicate a certain part of their week – possibly two days
– to dealing solely with this large group of child mental
health service-users.

He also stressed the importance of breaking down the “artificial
dichotomy” between child mental health and other children’s
services, calling for wider multi-disciplinary teams which would
include developmental psychiatrists, clinical psychologists,
clinical nurse specialists, speech and language therapists,
psychiatric social workers, occupational therapists, and
geneticists.

Consultant child and adolescent psychiatrist Dr Sarah Bernard
said there were “areas of the country where there was absolutely no
CAMHS (child and adolescent mental health services) services at
all”.

“In-patient services are also practically non-existent,” she
added. “There’s a massive lack of in-patient services for the
most severe mentally ill people with learning difficulties.
There’s a disaster waiting to happen.”

Bernard said training programmes needed to change to ensure that
anybody studying child and adolescent psychiatry should also have
to train in learning difficulties, and anybody training in learning
difficulties should have some experience of child and adolescent
psychiatry.

Vivian Hill, director of professional educational psychology at
the University of London, said different professional perspectives,
tensions in departmental objectives, and issues about who should
pay for services, were all obstacles to joined-up thinking.

She said many people working in the learning difficulty sector
were also very anxious about dealing with mental health and
behavioural issues, despite their prevalence among the client group
they dealt with.