Wednesday 20 August 2014

Youth mental health in the UK - remember the children with intellectual disability and autism

There is interest today in the apparently dire state of child and adolescent mental health services in the UK including a headline BBC News story.

The purpose of this brief blog is to encourage people entering the debate, and those who may join a "task force", to remember that within this topic there is a serious issue relating to mental health inequalities. Various disabilities and physical health conditions are associated with an increased chance that children will develop mental health problems. My focus in this blog is on children with intellectual disability (learning disability in UK health services language), and those with autism.

Our research using data from the ONS Child and Adolescent Mental Health surveys of British children shows that children with intellectual disability are about three times more likely to have high levels of behavioural and emotional problems than children without intellectual disability or autism. Children with autism had even higher levels of mental health problems.

We also know that these mental health inequalities emerge early in life for children with intellectual disability and/or autism. Again using nationally representative population survey data from the UK, we found that these inequalities have emerged at least by the time children are five years of age (and probably much earlier).

Earlier this year, working with colleagues from various Universities we also published data on the mental health of children with autism who also had intellectual disability and attended specialist autism schools. Again, we found higher rates of mental health problems compared to what would be expected for British school age children generally. Also very worrying was that we asked parents (and teachers) whether these children had any contact with child and adolescent mental health services in the previous six months. Only 20-25% of those children who currently had likely mental health problems were reported as having any mental health services contact in the preceding six months.

These research studies are based on large population studies or otherwise large samples. The findings confirm a general pattern of significant mental health inequalites for children with intellectual disability and/or autism, the early emergence of these inequalities, and a lack of access to mental health services for one of the most vulnerable groups of UK children.

Any discussion about youth mental health in the UK must include questions about how best to support this vulnerable group of children, and also how to start with early intervention to help to prevent mental health problems.

Young people with intellectual disability and autism are not a side issue in this debate. One estimate, again from UK population data, is that 14% of ALL children with a mental health problem in the UK will have an intellectual disability.

So, don't ignore these children and young people!

5 comments:

  1. Good points. As a mum with a child with autism and LD approaching adolescence, can I ask what were the most prevalent mental health problems you found? We never saw CAMHS unless drugs like Ritalin were in prospect.

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  2. For the reports from teachers, they reported emotional problems as the most prevalent; whilst reports from parents had hyperactivity/ADHD problems as the most prevalent. However, difficulties were elevated across the board (emotional, hyperactivity, conduct difficulties) compared to UK normative data for children - for parent and for teacher reports.

    Your final point is also very important. Our question was about any contact at all with mental health services. We didn't report data on what the contact was, nor could we know whether the contact was useful or appropriate. Access to psychological supports for children with autism (with LD in particular perhaps) is likely to be a real problem.

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