Read on Twitter
@roinnslainte some good points regarding autism but not sure that #sharingthevision addresses fully the access issues and specific needs of autistic people with mental health needs. Comments below, long tweet!
‘The scaling up of access to supports in primary care should help to reduce the over-reliance on specialist mental healthcare...developing further capacity for ADHD and autism-specific services will play a role in reducing the number of referrals into CAMHS'
What is the evidence for this? Many of the children who present to CAMHS with autism are presenting later with co-occurring mental health needs. We need to study the characteristics of referrals to CAMHS to get a true understanding of this.
The guidance in the CAMHS SOP quoted in #SharingtheVision states ‘Where the child or adolescent presents with a moderate-to-severe mental disorder and autism, CAMHS teams provide appropriate multi-disciplinary mental health assessment and treatment’
We know that mental health needs are often conflated with autism. Referrals to CAMHS are often judged inappropriate. Need mental health research in autism as highlighted in research priorities of the charity Autistic UK and as highlighted also by national advocacy such as @AsIAm
Regarding complex mental health needs rather than having specialist inpatient or intensive day programs #SharingtheVision states ‘A preferred approach is to develop a bespoke set of supports that address the needs of each individual case in the most appropriate setting.’
What does this look like, how is it resourced and how will we know if this is effective clinically? How many children, adolescents, adults with complex comorbidity are placed in private residential settings lacking expertise on the management/ treatment of complex mental health?
The profile of the mental health needs of the prison population needs to be explored to gather data on the prevalence of autism, intellectual disability and needs relating to addiction and dual diagnosis, often not specifically catered for by an associated model of care (MOC)
Bravo - this is really useful - but what about research regarding the mental health needs of autistic people and their needs around service provision more generally?
Rec 20: There should be further development of early intervention and assessment services in the primary care sector for children with ADHD and/or autism to include comprehensive multi-disciplinary and paediatric assessment and mental health consultation with the relevant CMHT,
How does this relate to the recent changes in AoN that no longer requires completion of a diagnostic assessment to determine need? How will this be resourced? Will the CMHT professionals be trained in diagnosing mental health comorbidity and resourced to provide interventions?
Rec 56: A tiered model of integrated service provision for individuals with dual diagnosis should be developed to ensure that pathways to care are clear. ...tiered models of support should be available to people with a dual diagnosis of ID and/or autism and mental health
Will pathways of care be finally made clear and based on needs rather than defining access to a service based on IQ? IQ is not a meaningful way to define need in the context of autism. There is a breadth of research evidence on this.
