Abstract
Background: Epilepsy is one of the most common chronic paediatric conditions. Children and young people with epilepsy are at a significantly higher risk of developing mental health problems relative to the general population, yet the majority of these problems are unrecognised and under-treated in clinical practice. Although there is little epilepsy-specific guidance as to what interventions to use, researchers suggest there is no reason why clinicians should not be using the evidence base. Given the poor prognosis of untreated mental health difficulties, this cohort study sought to identify what psychological treatment young people with epilepsy with mental health needs receive in routine practice. Methods: Participants were children and young people aged 3 to 18 attending paediatric neurology clinics. The parents of those children who met threshold for impairing symptoms on the Strengths and Difficulties questionnaire were asked to complete the Development and Well-being Assessment (DAWBA), an online clinical assessment designed to generate psychiatric diagnoses. Participants who met clinical threshold for a disorder according to the DAWBA were provided with a bespoke measure asking questions regarding their experience with treatment for mental health support. Results: 16 of the 46 parents who completed the DAWBA reported that they had experienced previous or current support for their child's mental health difficulties. The mental health support offered to families was highly variable, inadequate and often not clearly compliant with existing UK National Institute for Health and Clinical Excellence (NICE) guidelines for mental health treatment in children and young people. Conclusions: The present study demonstrates the inconsistency and inadequacy of mental health provision for children and young people with epilepsy. Future work should explore reasons for the treatments offered failing to adhere to existing guidance for mental health difficulties in children, as well as possible solutions to this.
Highlights
Epilepsy is one of the most common paediatric neurological conditions in childhood (Hirtz et al, 2007)
The UK National Institute for Health and Clinical Excellence (NICE) guidelines recommend that the psychological needs of children with epilepsy should be considered as part of routine care (NICE, 2012, p.52)
This study revealed that the majority of young people with mental health needs in epilepsy services were not receiving any intervention
Summary
Epilepsy is one of the most common paediatric neurological conditions in childhood (Hirtz et al, 2007). UK NICE guidelines (2013) recommend that, in children and young people without epilepsy who have mental health needs, those with disruptive behaviour disorders should be given approximately ten hourly sessions of a behavioural parenting intervention as a first-line treatment and those with social anxiety should be given 8–12 sessions of cognitive behaviour therapy of 45 minutes duration (NICE, 2013). Methods: Participants were children and young people aged 3 to 18 attending paediatric neurology clinics The parents of those children who met threshold for impairing symptoms on the Strengths and Difficulties questionnaire were asked to complete the Development and Well-being Assessment (DAWBA), an online clinical assessment designed to generate psychiatric diagnoses. Future work should explore reasons for the treatments offered failing to adhere to existing guidance for mental health difficulties in children, as well as possible solutions to this
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