Adult ADHD: How Big is the Problem? Delivering Effective Services for Adults with ADHD

Size: px
Start display at page:

Download "Adult ADHD: How Big is the Problem? Delivering Effective Services for Adults with ADHD"

Transcription

1 Adult ADHD: How Big is the Problem? Delivering Effective Services for Adults with ADHD North West Mental Health Commissioning Network 1 st March 2016 Dr Prathiba Chitsabesan Consultant Child and Adolescent Psychiatrist and Clinical Director (Pennine Care NHS Foundation Trust) Honorary Lecturer (University of Manchester- Offender Health Research Network) Clinical Advisor CAMHS Advisory Group (SCN)

2 Presentation ADHD Persistent and pervasive pattern of hyperactivity, inattention and impulsivity across settings George Still (1902) in children but studies on adults delayed until 1960 s US- initially called MBD Aetiology Neurobiological disorder- polygenetic (70-80% heritability) and environmental factors Dopamine and noradrenaline transmission disrupted in particular pathways including prefrontal cortex Definition/Diagnosis ICD-10- Hyperkinetic Disorder Early onset, persistent over time, pervasive across settings and associated with severe impairment DSM-V Changes from DSM-IV- lower threshold needed to meet diagnosis in adults

3 Epidemiology Prevalence Prevalence- 5% of children and young people (broader DSM criteria) and 1.5% (ICD-10); M>F- 4:1 Follow-up studies of ADHD in children (Farone et al., 2006) 15% retaining a full diagnosis by 25 years, further 50% retaining some symptoms leading to continued impairments in daily life Adults NICE (2008) % full criteria and 2-4% partial remission Pooled prevalence -2.5% (Simon et al., 2009) General Adult Psych OP Clinic North East England- 22% (Rao et al., 2011)

4 Co-morbidity Co-morbidity high in adults with ADHD (80%) for mental health needs and neurodevelopmental disorders UMASS Study (US Study) Depression 36% Generalised anxiety 27% Alcohol abuse/dependency- 36% Substance abuse/dependency- 34% Polderman et al., 2014 (Swedish study) 28-44% of adults with Autism Spectrum Disorder met criteria for ADHD Phillipsen et al.., 2008 (Dutch Study) 16% of female patients with Borderline Personality Disorder met criteria for ADHD Klein et al., 2009 (US Study) 47% of male patients with Antisocial Personality Disorder met criteria for ADHD

5 Impact Multiple domains Functioning- occupational, educational, money management Relationships- partners/marriage Mental health needs (mood disorders/aspd/ substance misuse) and risk of self-harm Physical health needs- higher rates of CVS, cancer (smoking), alcohol related disease, driving accidents, STDs, teenage pregnancy and premature mortality Increased association with offending- violent/persistent offending Cost to adult, family, services and public sector substantial long-term cost on society, estimated at around 100,000 per case-two-thirds of the cost takes the form of additional public expenditure on education and health care, with the remainder being reflected in reduced earnings (Centre for Mental Health, 2014).

6 Guidelines and Recommendations

7 Referral and Assessment NICE (2008) and Quality Statement 2: Identification and referral in adults (NICE, 2013) In recognition of adults with undiagnosed ADHD Commissioners should ensure that they commission specialist services for the assessment of adults with suspected ADHD Primary care/health and social care practitioners should be able to recognise and refer adults with symptoms of ADHD for specialist assessment Specialist teams should provide training to community and partner agencies around symptoms (primary care, AMHS etc) Specialist ADHD teams should be multi-disciplinary Assessment by a psychiatrist or mental health specialist with training, experience and knowledge of ADHD Full clinical and psychosocial assessment Assessment of co-morbidity and needs

8 Pharmacological Treatment First line treatment for adults with Moderate and Severe ADHD Pharmacological Choice of stimulants (methylphenidate and dexamphetamine) and non stimulants (atomoxetine) Effectiveness- Large effect size as for children (Faraone and Glatt, 2009) 60-70% adults respond to medication treatment Licensing Increasing number of medications licensed for use in adults Monitoring Cardiovascular changes such as increased pulse and blood pressure need to be monitored, although this is similar to many other drugs used in adults. Summary Appropriate funding to support care pathways including medication titration costs Development of SCPs Agreement between primary and specialist services in monitoring medication

9 Psychological Treatment NICE (2008) recommends adults with ADHD require integrated care that addresses a wide range of personal, social, educational and occupational needs Drug treatment for adults with ADHD should always form part of a comprehensive treatment programme Psycho-educational programmes are increasingly available for ADHD (selfhelp material) Cognitive behavioural therapy for Adult ADHD Less cost-effective in comparison to medication but opportunities for group interventions e.g CBT NICE (2008) suggest addition of CBT to medication for persistent symptoms Ensure treatment of co-morbidity CBT may be useful for those with co-morbid mood disorders Developing evidence for adult offenders with ADHD (R and R2)

10 Treatment Outcomes Addressing ADHD may have a three-fold impact: 1. Directly reducing symptoms 2. Improving occupational and social functioning 3. Reducing poor secondary mental health and physical health outcomes High risk populations The treatment of underlying ADHD may lead to improvements in comorbid disorders (substance abuse disorders including addiction, and anxiety and depression including the risk of suicide) Offenders/Crime 24% childhood ADHD, 6% full criteria in adulthood and 8% partial remission (Young et al., 2009) ADHD Treatment in adult offenders reduced reoffending by 32% for men and 41% for women (Lichtenstein et al., 2012)

11 Need for Change! Development of SCN Guidance for Children and Young People (2015) GM Mental Health Strategy Development of ADHD Lifespan Services

12 1. Service Planning 1. Identification of need and unmet need 3 main groups of service users to consider: Diagnosed and stabilized on medication from CAMHS/Paeds ADHD services Previously diagnosed in childhood and re-referred for medication treatment Referred for assessment and treatment 2. Multi-agency working and co-commissioning 3. Developing training programmes Primary care, community and specialist services 4. Workforce design and planning Capacity, confidence and competence in workforce across primary and specialist services

13 2. Referral from Community Services 1. Development of a multi-agency care pathway through local stakeholder events outlining the contribution of different stakeholders to the pathway 2. Stepped care model before referral of a adult with possible ADHD for assessment Initial screening role of rating scales (e.g Connors/ASRS) Support within the community for adults (strategies/advice) 3. Develop care pathways dependent on: ADHD Assessment and Treatment Needs Diagnosed and stabilised on treatment Needs medication stabilisation Needs assessment and treatment Co-morbidity (mental health/neurodevelopmental/offending)

14 3. Specialist Assessment 1. Specialist teams should be multi-disciplinary and consider the role of specialist ADHD nurses to provide more cost-effective models of care 2. ADHD nurses should act as a named contact for other services in Providing consultation and advice 3. Key differences from NICE (2008/13):- Role of standardised assessment protocol/screening tool for other practitioners (AMHS/SM teams) Investment in objective psychometric assessments to aid reliability of diagnosis and standardise care

15 4. Interventions 1. Behavioural interventions including self-help information should be available to adults Information and signposting Behavioural interventions for adults (role of voluntary and 3 rd Sector) Psycho-education Advice on strategies Use of Apps/technology Review group CBT (for those on medication with persistent symptoms and motivated)

16 4. Interventions 2. Pharmacological treatment should be monitored within ADHD clinics Local agreement between commissioners, specialist and primary care services regarding the role of each stakeholder in monitoring and prescribing through the use of shared care protocols Specialist services to consider role of ADHD nurses/advanced practitioners in cost-effective models of medication monitoring Monitor outcomes through the use of validated ADHD symptom scales e.g Connors/Wender Utah/ ADHD-RS IV) quality of life measures changes in functioning e.g sustaining employment possible role of objective measures (Qbtest for treatment optimisation)

17 Overwhelmed?

18 Confused?

19 Partnership Working

20 Thankyou

Adult Neurodevelopmental Services. ADHD Shared Protocol

Adult Neurodevelopmental Services. ADHD Shared Protocol Adult Neurodevelopmental Services ADHD Shared Protocol Issue 1: April 2016 1 2 Adult Neurodevelopmental Service Shared Care Protocol for Adult Attention Deficit Hyperactivity Disorder (ADHD) 1. BACKGROUND

More information

ADHD Training for General Practitioners

ADHD Training for General Practitioners ADHD Training for General Practitioners Learning Objectives Understand the stigma surrounding ADHD and develop ability to challenge stigma. Understand your role in the ADHD pathway. Understand what you

More information

Adult ADHD - New Models of Care

Adult ADHD - New Models of Care Adult ADHD - New Models of Care Mark Pitts Senior Clinical Nurse Specialist Adult ADHD Service, Maudsley Hospital & Lambeth Adult ADHD & Autism Service What is needed? NICE (2008) guidance postulates 1)

More information

Delivering Effective Services for

Delivering Effective Services for Delivering Effective Services for Children and Young People with ADHD Good practice guidance for commissioners and service providers across Greater Manchester Developed by the ADHD Project Subgroup CAMHS

More information

Dr S H Jawed Consultant General Adult Psychiatrist, Dorothy Pattison Hospital, Walsall Joint Lead Consultant for

Dr S H Jawed Consultant General Adult Psychiatrist, Dorothy Pattison Hospital, Walsall Joint Lead Consultant for Dr S H Jawed Syed.Jawed@dwmh.nhs.uk 01922607039 Consultant General Adult Psychiatrist, Dorothy Pattison Hospital, Walsall Joint Lead Consultant for Adult Neurodevelopmental Service, DWMHP NHS Trust Regional

More information

Outline & Objectives

Outline & Objectives 21/11/2017 ADHD Assessment and brief Intervention service: a multi-disciplinary perspective Kapil Sayal Outline & Objectives To be aware of the service context and development To understand these aspects

More information

Service Specification: Bristol and South Gloucestershire Specialist Substance Misuse Treatment Service January 2016

Service Specification: Bristol and South Gloucestershire Specialist Substance Misuse Treatment Service January 2016 This specification is an annex to the Service Specification for the provision of Child and Adolescent Mental Health Services. It must be read along with the overarching specification which applies to all

More information

Adult ADHD for GPs. Maria Mazfari Associate Nurse Consultant Adult ADHD Tina Profitt Clinical Nurse Specialist Adult ADHD

Adult ADHD for GPs. Maria Mazfari Associate Nurse Consultant Adult ADHD Tina Profitt Clinical Nurse Specialist Adult ADHD Adult ADHD for GPs Maria Mazfari Associate Nurse Consultant Adult ADHD Tina Profitt Clinical Nurse Specialist Adult ADHD I m a Believer.. Are You? What is ADHD? ADHD is a valid clinical condition defined

More information

NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE SCOPE

NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE SCOPE NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE 1 Guideline title SCOPE Personality disorder: the management and prevention of antisocial (dissocial) personality disorder 1.1 Short title Antisocial

More information

Adult ADHD Service Development. Dr Joe Johnson Consultant Psychiatrist Five Boroughs Partnership NHS Trust

Adult ADHD Service Development. Dr Joe Johnson Consultant Psychiatrist Five Boroughs Partnership NHS Trust Adult ADHD Service Development Dr Joe Johnson Consultant Psychiatrist Five Boroughs Partnership NHS Trust Consultant Psychiatrist in 5BP since 2005 My Background Working both in Community and Prison MH

More information

Clinical guideline Published: 24 September 2008 nice.org.uk/guidance/cg72

Clinical guideline Published: 24 September 2008 nice.org.uk/guidance/cg72 Attention deficit hyperactivity disorder: diagnosis and management Clinical guideline Published: 24 September 2008 nice.org.uk/guidance/cg72 NICE 2018. All rights reserved. Subject to Notice of rights

More information

GM ADHD Strategic Clinical Network. Training for Specialist ADHD Teams

GM ADHD Strategic Clinical Network. Training for Specialist ADHD Teams GM ADHD Strategic Clinical Network Training for Specialist ADHD Teams Learning Objectives Understand the stigma surrounding ADHD and develop ability to challenge stigma.. DSM-5 classification of ADHD ADHD

More information

NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE SCOPE. Personality Disorder: the clinical management of borderline personality disorder

NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE SCOPE. Personality Disorder: the clinical management of borderline personality disorder NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE 1 Guideline title SCOPE Personality Disorder: the clinical management of borderline personality disorder 1.1 Short title Borderline personality disorder

More information

Attention deficit hyperactivity disorder

Attention deficit hyperactivity disorder Attention deficit hyperactivity disorder Diagnosis and management of ADHD in children, young people and adults Issued: September 2008 last modified: March 2013 NICE clinical guideline 72 guidance.nice.org.uk/cg72

More information

Diagnosis and management of ADHD in children, young people and adults

Diagnosis and management of ADHD in children, young people and adults Issue date: September 2008 Attention deficit hyperactivity disorder Diagnosis and management of ADHD in children, young people and adults NICE clinical guideline 72 Developed by the National Collaborating

More information

METHYLPHENIDATE AND ATOMOXETINE TREATMENT OF ATTENTION DEFICIT HYPERACTIVITY DISORDER IN CHILDREN AND YOUNG PEOPLE

METHYLPHENIDATE AND ATOMOXETINE TREATMENT OF ATTENTION DEFICIT HYPERACTIVITY DISORDER IN CHILDREN AND YOUNG PEOPLE NOTTINGHAMSHIRE AREA PRESCRIBING COMMITTEE SHARED CARE PROTOCOL AGREEMENT METHYLPHENIDATE AND ATOMOXETINE TREATMENT OF ATTENTION DEFICIT HYPERACTIVITY DISORDER IN CHILDREN AND YOUNG PEOPLE OBJECTIVES To

More information

Adult ADHD How Big is the Problem? National Perspective

Adult ADHD How Big is the Problem? National Perspective Adult ADHD How Big is the Problem? National Perspective East Midlands Mental Health Commissioning Network Conference March 23rd 2016 Professor Chris Hollis Adult ADHD: National Perspective Adult ADHD:

More information

Professor Tim Kendall

Professor Tim Kendall Professor Tim Kendall Director of National Collaborating Centre for Mental Health, Royal College of Psychiatrists and Visiting Professor UCL Medical Director and Consultant Psychiatrist for homeless people,

More information

Project Initiation Document:

Project Initiation Document: Project Initiation Document: Lancashire Support Services for Children, Young People, Families and Carers Affected by Autistic Spectrum Disorder (ASD) and Diagnosis 1. Background The Children and Young

More information

Methylphenidate Shared Care Agreement For attention deficit hyperactivity disorder (ADHD) in adults Effective Shared Care Agreement

Methylphenidate Shared Care Agreement For attention deficit hyperactivity disorder (ADHD) in adults Effective Shared Care Agreement Methylphenidate Shared Care Agreement For attention deficit hyperactivity disorder (ADHD) in adults Effective Shared Care Agreement Section 1: Shared Care arrangements and responsibilities Section 1.1

More information

NICE quality standard for attention deficit hyperactivity disorder (QS39)

NICE quality standard for attention deficit hyperactivity disorder (QS39) QS 39 NICE quality standard for attention deficit hyperactivity disorder (QS39) NICE provided the content for this booklet which is independent of any company or product advertised 2 THE COMMISSIONING

More information

Disclosures. Speakers and Consultancy fees from. Lundbeck Janssen Eli Lilly

Disclosures. Speakers and Consultancy fees from. Lundbeck Janssen Eli Lilly Dr S H Jawed Consultant General Adult Psychiatrist, Dorothy Pattison Hospital, Walsall Joint Lead Consultant for Adult Neurodevelopmental Service, DWMHP NHS Trust Regional Lead, UK Adult ADHD Network (UKAAN)

More information

If a specialist asks a GP to prescribe ADHD medication in relation to this disease, the GP should reply to this request as soon as practicable.

If a specialist asks a GP to prescribe ADHD medication in relation to this disease, the GP should reply to this request as soon as practicable. Shared Care Protocol for the Methylphenidate and the Management of Attention Deficit Hyperactivity Disorder (ADHD) for children from 4 years up to 17 years and 364 days 1.0 INTRODUCTION The medical assessment

More information

Issue date September 2010 (Reviewed October 2013) Clinicians from Andrew Lang Centre, Mental. Specialist Pharmacist & Formulary Pharmacist

Issue date September 2010 (Reviewed October 2013) Clinicians from Andrew Lang Centre, Mental. Specialist Pharmacist & Formulary Pharmacist Title Document Type Issue no Shared care guidelines in the Treatment of Attention Deficit/ Hyperactivity Disorders Shared Care Guidelines and Information for GPs Clinical Governance Support Team Use Issue

More information

ASD and ADHD Pathway. Pride in our children s, young people s and families s e r v i c e s A member of Cambridge University Health Partners

ASD and ADHD Pathway. Pride in our children s, young people s and families s e r v i c e s A member of Cambridge University Health Partners ASD and ADHD Pathway 30-11-2017 Pride in our care Pride in our children s, young people s and families s e r v i c e s A member of Cambridge University Health Partners ADHD NICE Guidance: Organisation

More information

NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE SCOPE

NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE SCOPE NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE 1 Guideline title SCOPE Drug Misuse: opiate detoxification of drug misusers in the community, hospital and prison. 1.1 Short title Drug misuse detoxification

More information

Mental Health Strategy. Easy Read

Mental Health Strategy. Easy Read Mental Health Strategy Easy Read Mental Health Strategy Easy Read The Scottish Government, Edinburgh 2012 Crown copyright 2012 You may re-use this information (excluding logos and images) free of charge

More information

Eating Disorders Young People s Service (EDYS, Alder Hey CAMHS)

Eating Disorders Young People s Service (EDYS, Alder Hey CAMHS) Eating Disorders Young People s Service (EDYS, Alder Hey CAMHS) A Local Comprehensive Eating Disorder Service for Young People in Liverpool and Sefton. 1 1. Introduction: Alder Hey Children s NHS Foundation

More information

Topic proposal. 1. What is the problem/need for a guideline/clinical scenario?

Topic proposal. 1. What is the problem/need for a guideline/clinical scenario? Topic proposal I understand that this proposal will be retained by the Programme Lead and be made available on the website for time period that the proposal is being considered. Only proposals with a completed

More information

NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE Centre for Clinical Practice SCOPE

NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE Centre for Clinical Practice SCOPE NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE Centre for Clinical Practice 1 Guideline title SCOPE Autism: the management and support of children and young people on the autism spectrum 1.1 Short

More information

Attention Deficit Hyperactivity Disorder: Information for Nurse led ADHD Clinics and School Nurses

Attention Deficit Hyperactivity Disorder: Information for Nurse led ADHD Clinics and School Nurses Attention Deficit Hyperactivity Disorder: Information for Nurse led ADHD Clinics and School Nurses What is ADHD? What causes ADHD? The role of the specialist and school nurse in ADHD care Obtaining an

More information

Bournemouth, Dorset and Poole Prescribing Forum

Bournemouth, Dorset and Poole Prescribing Forum SHARED CARE GUIDELINE FOR THE USE OF ATOMOXETINE IN ADULTS WITH ATTENTION DEFICIT HYPERACTIVITY DISORDER INDICATION Atomoxetine is a non-stimulant non-amphetamine inhibitor of noradrenaline reuptake. It

More information

Attention Deficit Hyperactivity Disorder

Attention Deficit Hyperactivity Disorder Page 1 of 5 Attention Deficit Hyperactivity Disorder ADHD is a common condition that mainly affects behaviour. Children with this condition show persistent restlessness, impulsiveness and/or inattention.

More information

An Overview of the ADHD Pathway for Adults in Devon/Torbay

An Overview of the ADHD Pathway for Adults in Devon/Torbay An Overview of the ADHD Pathway for Adults in Devon/Torbay Andrew Blewett, also Charles Antwi, Mark Jay, Ruth Marlow, Rachel Pebworth, Abbie Turner, Rachel Webb January 2016 Resource/capacity 0.8 clinical

More information

Dr Jane McCarthy MB ChB MD MRCGP FRCPsych

Dr Jane McCarthy MB ChB MD MRCGP FRCPsych Dr Jane McCarthy MB ChB MD MRCGP FRCPsych Consultant Psychiatrist in Intellectual Disability, East London NHS Foundation Trust and Visiting Senior Lecturer, Institute of Psychiatry, Psychology & Neuroscience,

More information

Surveillance report Published: 13 April 2017 nice.org.uk. NICE All rights reserved.

Surveillance report Published: 13 April 2017 nice.org.uk. NICE All rights reserved. Surveillance report 2017 Antisocial behaviour and conduct disorders in children and young people: recognition and management (2013) NICE guideline CG158 Surveillance report Published: 13 April 2017 nice.org.uk

More information

Week 2: Disorders of Childhood

Week 2: Disorders of Childhood Week 2: Disorders of Childhood What are neurodevelopmental disorders? A group of conditions with onset in the developmental period Disorders of the brain The disorders manifest early in development, often

More information

Kent Joint Commissioning Action Plan For Adults with Autism and or ADHD (2017 / 2021)

Kent Joint Commissioning Action Plan For Adults with Autism and or ADHD (2017 / 2021) Easy Read Kent Joint Commissioning Action Plan For Adults with Autism and or ADHD (2017 / 2021) Action Plan The plan was developed to address the needs identified from the Kent Autism Strategy and Joint

More information

The National perspective Public Health England s vision, mission and priorities

The National perspective Public Health England s vision, mission and priorities The National perspective Public Health England s vision, mission and priorities Dr Ann Hoskins Director Children, Young People and Families Public Health England May 2013 Mission Public Health England

More information

NICE guideline Published: 14 March 2018 nice.org.uk/guidance/ng87

NICE guideline Published: 14 March 2018 nice.org.uk/guidance/ng87 Attention deficit hyperactivity disorder: diagnosis and management NICE guideline Published: 14 March 2018 nice.org.uk/guidance/ng87 NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-ofrights).

More information

ADHD in Adults Service Development

ADHD in Adults Service Development ADHD in Adults Service Development March 23, 2016 East Midlands Mental Health Commissioning Network Conference Muhammad Arif Leicestershire Partnership NHS Trust Services for Adults with ADHD a defining

More information

Children and Young People s Emotional Wellbeing and Mental Health. Transformation Plan

Children and Young People s Emotional Wellbeing and Mental Health. Transformation Plan Children and Young People s Emotional Wellbeing and Mental Health Transformation Plan 2015-2020 2 Summary The Government is making the mental health and emotional wellbeing of children and young people

More information

Attention Deficit Hyperactivity Disorder (ADHD) in adults Patient information leaflet

Attention Deficit Hyperactivity Disorder (ADHD) in adults Patient information leaflet Attention Deficit Hyperactivity Disorder (ADHD) in adults Patient information leaflet Introduction This leaflet provides information about the condition Attention Deficit Hyperactivity Disorder (ADHD),

More information

MRCPsych Pharmacology of ADHD treatment. Dr Xanthe Barkla, Consultant Child and Adolescent Psychiatrist

MRCPsych Pharmacology of ADHD treatment. Dr Xanthe Barkla, Consultant Child and Adolescent Psychiatrist MRCPsych Pharmacology of ADHD treatment Dr Xanthe Barkla, Consultant Child and Adolescent Psychiatrist 04 01 17 Curriculum mapping MRCPsych Paper A(ii) covers clinical psychopharmacology MRCPsych Syllabus:

More information

NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE SCOPE

NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE SCOPE NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE 1 Guideline title SCOPE Drug Misuse: opiate detoxification of drug misusers in the community, hospital and prison. 1.1 Short title Drug misuse detoxification

More information

SCHEDULE 2 THE SERVICES

SCHEDULE 2 THE SERVICES 1 SCHEDULE 2 THE SERVICES A. Service Specifications Mandatory headings 1 4: mandatory but detail for local determination and agreement Optional headings 5-7: optional to use, detail for local determination

More information

Mental Health & Wellbeing Strategy

Mental Health & Wellbeing Strategy getting it right for e ery child in Aberdeenshire Mental Health & Wellbeing Strategy 2016-2019 NHS Grampian 2 Our vision is that all children and young people are mentally flourishing! Introduction and

More information

Children & Young People s Mental Health: Policy Landscape

Children & Young People s Mental Health: Policy Landscape Children & Young People s Mental Health: Policy Landscape Prof Dame Sue Bailey, Chair, Children & Young People s Mental Health Coalition Conflicts of interest /loyalty Chair, Academy of Medical Royal Colleges

More information

Implementing NICE guidance

Implementing NICE guidance Implementing NICE guidance Penny Williams Speech and Language Therapist NICE clinical guideline 128 September 2011 What this presentation covers Background Development Scope of the Guideline Key Recommendations

More information

Guideline scope Smoking cessation interventions and services

Guideline scope Smoking cessation interventions and services 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 Topic NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE Guideline scope Smoking cessation interventions and services This guideline

More information

A Health Needs Assessment for Children and Adults with Neurodevelopmental Conditions in Liverpool

A Health Needs Assessment for Children and Adults with Neurodevelopmental Conditions in Liverpool January 2017 A Health Needs Assessment for Children and Adults with Neurodevelopmental Conditions in Liverpool Jane Harris, Hannah Madden, Jane Oyston, Heather Billington, Collette Venturas, Lorna Porcellato

More information

Placing mental health at the heart of what we do

Placing mental health at the heart of what we do 27 Jul 2018 Placing mental health at the heart of what we do Welcome to the first edition of the partnership bulletin from Cheshire and Merseyside Mental Health Programme Board. Who are we? Mental Health

More information

Sheffield s Emotional Wellbeing and Mental Health Strategy for Children and Young People

Sheffield s Emotional Wellbeing and Mental Health Strategy for Children and Young People Sheffield s Emotional Wellbeing and Mental Health Strategy for Children and Young People The Sheffield Vision In Sheffield we want every child and young person to have access to early help in supporting

More information

AUTISM ACTION PLAN FOR THE ROYAL BOROUGH OF GREENWICH

AUTISM ACTION PLAN FOR THE ROYAL BOROUGH OF GREENWICH AUTISM ACTION PLAN FOR THE ROYAL BOROUGH OF GREENWICH NATIONAL CONTEXT Fulfilling and Rewarding Lives (2010) is the Government s strategy for adults with Autistic Spectrum Disorders. It sets out the Government

More information

Dual Diagnosis Pathway

Dual Diagnosis Pathway Dual Diagnosis Pathway Document level: Trustwide (TW) Code: CP23 Issue number: 7 Lead executive Authors details Type of document Target audience Document purpose Medical Director Consultant Psychiatrist

More information

Autism Spectrum Conditions

Autism Spectrum Conditions Autism Spectrum Conditions June 2017 Produced by Abraham George: Public Health Consultant (abraham.george@kent.gov.uk) Gerrard Abi-Aad: Head of Health Intelligence (gerrard.abi-aad@kent.gov.uk) Correspondence

More information

AUTISM STRATEGY FOR ADULTS IN BIRMINGHAM

AUTISM STRATEGY FOR ADULTS IN BIRMINGHAM CONSULTATION DOCUMENT AUTISM STRATEGY FOR ADULTS IN BIRMINGHAM 2013 2016 HELPING ADULTS WITH AUTISM TO ACHIEVE FULFILLING AND REWARDING LIVES RAISING AWARENESS TO INFORM, IMPLEMENT AND IMPROVE Strategy

More information

PUBLIC HEALTH INTERVENTION GUIDANCE SCOPE

PUBLIC HEALTH INTERVENTION GUIDANCE SCOPE NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE PUBLIC HEALTH INTERVENTION GUIDANCE 1 Guidance title SCOPE Interventions delivered in primary and secondary schools to prevent and/or reduce alcohol

More information

Guideline scope Persistent pain: assessment and management

Guideline scope Persistent pain: assessment and management National Institute for Health and Clinical Excellence [document type for example, IFP, QRG] on [topic] Document cover sheet Date Version number Editor 30/08/2017 1 NGC Action 1 2 3 4 5 6 7 8 9 10 11 12

More information

Attention Deficit and Hyperkinetic Disorders. Services Over Scotland. Final Report November Scrutiny

Attention Deficit and Hyperkinetic Disorders. Services Over Scotland. Final Report November Scrutiny Attention Deficit and Hyperkinetic Disorders Services Over Scotland Final Report November 2012 Scrutiny Healthcare Improvement Scotland is committed to equality. We have assessed the performance assessment

More information

They are updated regularly as new NICE guidance is published. To view the latest version of this NICE Pathway see:

They are updated regularly as new NICE guidance is published. To view the latest version of this NICE Pathway see: Ongoing care for adults with psychosis or schizophrenia bring together everything NICE says on a topic in an interactive flowchart. are interactive and designed to be used online. They are updated regularly

More information

Dr Jane McCarthy Consultant Psychiatrist, East London NHS Foundation Trust & Visiting Senior Lecturer, Department of Forensic & Neurodevelopmental

Dr Jane McCarthy Consultant Psychiatrist, East London NHS Foundation Trust & Visiting Senior Lecturer, Department of Forensic & Neurodevelopmental Dr Jane McCarthy Consultant Psychiatrist, East London NHS Foundation Trust & Visiting Senior Lecturer, Department of Forensic & Neurodevelopmental Sciences Department, King s College London Prevalence

More information

Alcohol and Drug Commissioning Framework for Northern Ireland Consultation Questionnaire.

Alcohol and Drug Commissioning Framework for Northern Ireland Consultation Questionnaire. Alcohol and Drug Commissioning Framework for Northern Ireland 2013-16 Consultation Questionnaire. This questionnaire has been designed to help stakeholders respond to the above framework. Written responses

More information

NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE SCOPE. Type 2 diabetes: the management of type 2 diabetes (update)

NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE SCOPE. Type 2 diabetes: the management of type 2 diabetes (update) NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE 1 Guideline title SCOPE Type 2 diabetes: the management of type 2 diabetes (update) 1.1 Short title Type 2 diabetes (update) 2 Background a) The National

More information

Dr Belinda McCall Consultant Geriatrician

Dr Belinda McCall Consultant Geriatrician Dr Belinda McCall Consultant Geriatrician Overview Background to our service Project Initial service provision Further developments Benefits of a geriatrician Questions Background National Dementia Strategy

More information

HEKSS CHILD & ADOLESCENT PSYCHIATRY PROGRAMME - HST Trainee Job Description. HST TRAINEE Community Eating Disorders Child and Adolescent

HEKSS CHILD & ADOLESCENT PSYCHIATRY PROGRAMME - HST Trainee Job Description. HST TRAINEE Community Eating Disorders Child and Adolescent HEKSS CHILD & ADOLESCENT PSYCHIATRY PROGRAMME - HST Trainee Job Description Job Title: HST TRAINEE Community Eating Disorders Child and National Post Number: Educational / Supervisor: Base: Hours of Work:

More information

MANAGEMENT OF DUAL DIAGNOSIS

MANAGEMENT OF DUAL DIAGNOSIS MANAGEMENT OF DUAL DIAGNOSIS David Kingdon University of Southampton/ Southern Health Foundation Trust, Southampton, UK Public Health England guidance on Co- existing alcohol and drug misuse with mental

More information

Alberta Alcohol and Drug Abuse Commission. POSITION ON ADDICTION AND MENTAL HEALTH February 2007

Alberta Alcohol and Drug Abuse Commission. POSITION ON ADDICTION AND MENTAL HEALTH February 2007 Alberta Alcohol and Drug Abuse Commission POSITION ON ADDICTION AND MENTAL HEALTH POSITION The Alberta Alcohol and Drug Abuse Commission (AADAC) recognizes that among clients with addiction problems, there

More information

PROCEDURES AND GUIDANCE

PROCEDURES AND GUIDANCE PROCEDURES AND GUIDANCE Working with Substance Misusing Parents and those who come into Regular Contact with Children and Young People Date of original document July 2009 Date document reviewed April 2016

More information

Recommendations from the Devon Prisons Health Needs Assessment. HMP Exeter, HMP Channings Wood and HMP Dartmoor

Recommendations from the Devon Prisons Health Needs Assessment. HMP Exeter, HMP Channings Wood and HMP Dartmoor from the Devon Prisons Health Needs Assessment HMP Exeter, HMP Channings Wood and HMP Dartmoor 2011-2012 In April 2006 the responsibility for prison healthcare transferred from HM Prison Service to the

More information

They are updated regularly as new NICE guidance is published. To view the latest version of this NICE Pathway see:

They are updated regularly as new NICE guidance is published. To view the latest version of this NICE Pathway see: Coexisting mental disorders in adults with autism spectrum disorder bring together everything NICE says on a topic in an interactive flowchart. are interactive and designed to be used online. They are

More information

Additional file 1: Table S1. Themes developed from review of gatekeeper GP attitudes and knowledge regarding ADHD

Additional file 1: Table S1. Themes developed from review of gatekeeper GP attitudes and knowledge regarding ADHD Additional file 1: Table S1. Themes developed from review of gatekeeper GP attitudes and knowledge regarding ADHD Recognition rate GP non-recognition was main barrier to specialist services. Only 12% children

More information

Summary of the Health Needs in Rugby Borough

Summary of the Health Needs in Rugby Borough Rugby Borough Summary of the Health Needs in Rugby Borough Domain Indicator Rugby Borough 2010 Trend Warwickshire England Data Communities Children's and young people Adult's health and lifestyle Disease

More information

Addiction and Substance misuse pathways

Addiction and Substance misuse pathways Addiction and Substance misuse pathways Gordon Morse Chief Medical Officer Turning Point UK Gordon Morse statement of interests Sole employer Turning Point Some unpaid advisory work to the Hepatitis C

More information

Oxleas CAMHS Dr Joanna Sales Clinical Director. Adolescent problems: Depression Deliberate Self Harm Early Intervention in Psychosis

Oxleas CAMHS Dr Joanna Sales Clinical Director. Adolescent problems: Depression Deliberate Self Harm Early Intervention in Psychosis Oxleas CAMHS Dr Joanna Sales Clinical Director Adolescent problems: Depression Deliberate Self Harm Early Intervention in Psychosis PREVALENCE At any one time, the estimated number of children and young

More information

Discussion. What phrase best describes your beliefs about a diagnosis of AD(H)D in adults? Unconvinced Sceptical Open-minded Accepting Unsure

Discussion. What phrase best describes your beliefs about a diagnosis of AD(H)D in adults? Unconvinced Sceptical Open-minded Accepting Unsure ADHD and Addictions Discussion What phrase best describes your beliefs about a diagnosis of AD(H)D in adults? Unconvinced Sceptical Open-minded Accepting Unsure Aims of Training To have an understanding

More information

Psychosis with coexisting substance misuse

Psychosis with coexisting substance misuse Psychosis with coexisting substance misuse Assessment and management in adults and young people Issued: March 2011 NICE clinical guideline 120 guidance.nice.org.uk/cg120 NICE has accredited the process

More information

Achieve. Salford Young People s Service. Salford Recovery

Achieve. Salford Young People s Service. Salford Recovery Achieve Salford Young People s Service Achieve Salford Recovery Services Achieve SAlford recovery ServiceS Achieve Salford Recovery Services brings together people from a range of organisations, backgrounds

More information

Adult Psychiatric Morbidity Survey (APMS) 2014 Part of a national Mental Health Survey Programme

Adult Psychiatric Morbidity Survey (APMS) 2014 Part of a national Mental Health Survey Programme Adult Psychiatric Morbidity Survey (APMS) 2014 Part of a national Mental Health Survey Programme About the Adult Psychiatric Morbidity Survey (APMS) 2014 The Adult Psychiatric Morbidity Survey (APMS) 2014

More information

Nikki Mallinder on behalf of Linda Honey. Karen Thorburn Date: 04/10/18

Nikki Mallinder on behalf of Linda Honey. Karen Thorburn Date: 04/10/18 Agenda item: 7 ii Paper no: PCCC ic 20-18 Title of Report: Status: Committee: Venue: Update to the Attention Deficit Hyperactivity Disorder (ADHD) in Childhood) 12 monthly physical medication monitoring

More information

KEY QUESTIONS What outcome do you want to achieve for mental health in Scotland? What specific steps can be taken to achieve change?

KEY QUESTIONS What outcome do you want to achieve for mental health in Scotland? What specific steps can be taken to achieve change? SCOTTISH GOVERNMENT: NEXT MENTAL HEALTH STRATEGY Background The current Mental Health Strategy covers the period 2012 to 2015. We are working on the development of the next strategy for Mental Health.

More information

Community alcohol detoxification in primary care

Community alcohol detoxification in primary care Community alcohol detoxification in primary care 1. Purpose The purpose of this primary care enhanced service is to improve the health and quality of life of people whose health may be compromised by their

More information

Making Sense. Adults with Asperger Syndrome

Making Sense. Adults with Asperger Syndrome Making Sense Adults with Asperger Syndrome What is Asperger syndrome? Asperger syndrome is a lifelong neurodevelopmental condition which is part of the Autism Spectrum (also sometimes called Autism Spectrum

More information

Attention Deficit Hyperactivity Disorder

Attention Deficit Hyperactivity Disorder AMS-MOH CLINICAL PRACTICE GUIDELINES 1/2014 Attention Deficit Hyperactivity Disorder Academy of Medicine, Singapore College of Paediatrics and Child Health, Singapore College of Family Physicians Singapore

More information

IMPLEMENTING NICE GUIDELINES

IMPLEMENTING NICE GUIDELINES IMPLEMENTING NICE GUIDELINES Coexisting severe mental illness and substance misuse: community health and social care services NICE guideline [NG58]. November 2016 Dr Raffaella Margherita Milani Course

More information

Social Anxiety Disorder

Social Anxiety Disorder Social Anxiety Disorder Stakeholder Workshop Notes 4 th February 2011 1. Suggested guideline development group composition Are all the suggested members (and the numbers of each type of member) appropriate

More information

(Travel across Suffolk to other areas will be required) Salary: 25,000 pa plus 1% pension contribution rising to 3% by April 2019

(Travel across Suffolk to other areas will be required) Salary: 25,000 pa plus 1% pension contribution rising to 3% by April 2019 Job Description Job title: Location: Pregnancy Lead James Paget Hospital/Lowestoft (Travel across Suffolk to other areas will be required) Hours: 37.5 hours Salary: 25,000 pa plus 1% pension contribution

More information

CAMHS: Focus on Self-Harm, Suicidal Ideation in Adolescents. Nov 8 th 2018

CAMHS: Focus on Self-Harm, Suicidal Ideation in Adolescents. Nov 8 th 2018 CAMHS: Focus on Self-Harm, Suicidal Ideation in Adolescents Nov 8 th 2018 Introductions Mel Clarke, Clinical Nurse Specialist, CAMHS Emergency Care Service (CECS) Dr. Gili Orbach, Clinical Psychologist,

More information

To approve Primary Care Commissioning Committees in Common Date: 9/11/18. NWS CCG 58 Church St, Weybridge, Surrey, KT13 8DP

To approve Primary Care Commissioning Committees in Common Date: 9/11/18. NWS CCG 58 Church St, Weybridge, Surrey, KT13 8DP Agenda item: 9 Paper no: PCCC ic 31-18 Title of Report: Status: Committee: Attention Deficit Hyperactivity Disorder (ADHD) in children 6-17 years old - 12 monthly review monitoring for CNS stimulants,

More information

The next steps

The next steps Greater Manchester Hepatitis C Strategy The next steps 2010-2013 Endorsed by GM Director of Public Health group January 2011 Hepatitis Greater Manchester Hepatitis C Strategy 1. Introduction The Greater

More information

Clinical guideline Published: 23 March 2011 nice.org.uk/guidance/cg120

Clinical guideline Published: 23 March 2011 nice.org.uk/guidance/cg120 Coexisting severe ere mental illness (psychosis) and substance misuse: assessment and management in healthcare settings Clinical guideline Published: 23 March 2011 nice.org.uk/guidance/cg120 NICE 2018.

More information

ADHD Guidance September 2013

ADHD Guidance September 2013 ADHD Guidance September 2013 This guidance has been developed from the SASC convened ADHD Consensus Meeting chaired by Prof Philip Asherson held at Oxford University in May 2013 and subsequent consultations

More information

Guideline scope Hypertension in adults (update)

Guideline scope Hypertension in adults (update) NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE Guideline scope Hypertension in adults (update) This guideline will update the NICE guideline on hypertension in adults (CG127). The guideline will be

More information

NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE SCOPE

NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE SCOPE NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE 1 Guideline title SCOPE Psychosis and schizophrenia in children and young people: recognition and management 1.1 Short title Psychosis and schizophrenia

More information

Hospital Authority Convention -- Development of an Integrated Service in the Management of Childhood and Adolescent Depression in Hong Kong

Hospital Authority Convention -- Development of an Integrated Service in the Management of Childhood and Adolescent Depression in Hong Kong Hospital Authority Convention -- Development of an Integrated Service in the Management of Childhood and Adolescent Depression in Hong Kong Dr. Tam Fung Ling Associate Consultant CAP, Castle Peak Hospital

More information

Parity: Innovation in Practice

Parity: Innovation in Practice Parity: Innovation in Practice Karen Turner Director of Mental Health 11 February 2016 Why does parity matter? 1:4 adults experience at least one diagnosable mental health problem a year 1:10 children

More information

The links between physical health in mental health

The links between physical health in mental health The links between physical health in mental health A holistic approach to managing mental and physical health is needed. Physical and mental health are inextricably linked 1 What is the problem? It is

More information

SHARED CARE PROTOCOL FOR THE PRESCRIBING AND MONITORING OF MEDICINES FOR ATTENTION-DEFICIT HYPERACTIVITY DISORDER (ADHD)

SHARED CARE PROTOCOL FOR THE PRESCRIBING AND MONITORING OF MEDICINES FOR ATTENTION-DEFICIT HYPERACTIVITY DISORDER (ADHD) SHARED CARE PROTOCOL FOR THE PRESCRIBING AND MONITORING OF MEDICINES FOR ATTENTION-DEFICIT HYPERACTIVITY DISORDER (ADHD) 1. Introduction This protocol describes how patients prescribed medicines for ADHD

More information

Substance Misuse in Older People

Substance Misuse in Older People Substance Misuse in Older People Dr Tony Rao Consultant Old Age Psychiatrist, SLAM NHS Foundation Trust Visiting Researcher, Institute of Psychiatry, Neurology and Neuroscience Chair of Substance Misuse

More information

Adult ADHD Service in Northamptonshire. Kobus van Rensburg - Consultant Clinical Psychologist UKAAN 7 th International Congress 22 nd September 2017

Adult ADHD Service in Northamptonshire. Kobus van Rensburg - Consultant Clinical Psychologist UKAAN 7 th International Congress 22 nd September 2017 Adult ADHD Service in Northamptonshire Kobus van Rensburg - Consultant Clinical Psychologist UKAAN 7 th International Congress 22 nd September 2017 14 th October 2012 Speed of Sound = 768 miles/hour Felix

More information