Mental Health Needs/Service Provision for Children and Adolescents with Challenging Behaviour/Learning Disability Dr Sarah Bernard Consultant Psychiatrist The Michael Rutter Centre Background Children with LD are a seriously neglected group. High risk of behavioural/mental health problems (50-95%) Morbidity impacts on child, family, school. Input can, AND DOES, make a difference DoH has been addressing the gaps in service provision Current Situation Varies according to district CAMHS vs LD psychiatry services Variety of models – CAMHS, child neuropsych., lifespan, paediatric and others Promotion of child 1st model – this supported by NSF Training is a priority What is needed - assessment MDT approach Understanding of child psychopathology Understanding of disability Flexible approach – community based Multiagency working Cultural sensitivity Understanding of safeguarding What is needed - management MDT/multiagency approach Behavioural interventions – not short term Role of medication Impact of environment – education Respite Emergency protocol Ongoing review and monitoring The MDT Psychiatry Psychology Behavioural Therapy SALT Social Services OT Other…….. The Future A comprehensive CAMHS for all Appropriate provision – local and national/specialist More research/evidence based practice Discussion points What is challenging behaviour? How does the definition fit into a CAMHS service model? Current financial constraints (new services not likely to be developed) Motivation and interest