Transitional services for neurodevelopmental disorders

As Verity & Coates (Psychiatric Bulletin, March 2007, 31, ), our service also recognised that there was little specialised provision for young people with attention-deficit hyperactivity disorder (ADHD) beyond the upper age limit of child and adolescent mental health services (CAMHS), but also recognised a need for young people with autistic-spectrum disorders.

A neurodevelopmental disorders clinic has been funded to extend the upper age limit of the local CAMHS by a year, giving the young person an additional year to consider a trial without medication. The young person and their family are helped to access voluntary and statutory agencies for support, educational, vocational and leisure opportunities, and housing and financial aid.

Our service also has limitations, with no additional nursing, social work or psychology input. The greatest limitation is the lack of adult services. Of the seven young people seen in 2006, only one met the criteria for referral to adult services. One young person was able to reduce and stop medication successfully. For one young person, the general practitioner agreed to take over prescribing and monitoring. For the others, there are no appropriate adult services except in the private sector. There is currently no tertiary service for adults with ADHD locally and those with autistic-spectrum disorders are considered too able for learning disability services.

Although it has been recognised that adolescents with mental health problems have been poorly served (Singh et al, 2005), and there has been development in services for early psychosis and transitional arrangements between CAMHS and adult services, the group of young people with neurodevelopmental disorders has been forgotten.