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Developing Mental Health Services for Children and Adolescents with Learning Disabilities: A Toolkit for Clinicians Edited by Dr Sarah Bernard & Professor Jeremy Turk RCPsych Publications, 2009, £10.00, pb, 59 pp. ISBN: 9781904671619

Published online by Cambridge University Press:  02 January 2018

Harriet Stewart*
Affiliation:
Tower Hamlets CAMHS West Team, 16–18 Greatorex Street, London E1 5NF, UK, email: harriet.stewart@eastlondon.nhs.uk
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Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Copyright © The Royal College of Psychiatrists, 2010

This informative toolkit for clinicians was a response to the recommendations of the National Service Framework for Children and the Public Service Agreement 12 (2007). As part of the comprehensive spending review, these documents set out the government's agenda for improving the physical, mental and emotional health of all children, emphasising the needs of children with a learning disability. The outcome of such government interest has been a proliferation in the number of child and adolescent mental health service (CAMHS) jobs, with learning disability as their focus.

As the subtitle implies, this book is designed as a practical resource for those working with this group of children. These include the ‘Do Once and Share’ project and its care pathway. They have been useful in defining exactly what kind of support is needed and how this should be commissioned and provided. The Toolkit begins with an epidemiological overview setting out the need for services for children and young people with a learning disability. The authors go on to produce a helpful calculation of the numbers of children and young people with learning disabilities in a typical London borough who would be in need of mental health evaluation and input.

The book describes what kind of work a mental health service for children and young people with a learning disability should take on. There should be scope for the assessment of social communication disorders (e.g. autism and Asperger syndrome) and other comorbid conditions including attention-deficit hyperactivity disorder, depression, psychosis, Tourette syndrome, and challenging behaviours. Challenging behaviours include self-injury, aggression, persistent spitting, self-induced vomiting, persistent masturbation and other sexualised behaviours. The authors stress the importance of management always including the multidisciplinary team, the family, the school and Social Services. The Toolkit gives helpful advice for psychiatrists on prescribing for this group of children and young people.

What is the ideal composition of the multidisciplinary team providing a service for children and young people with a learning disability? The strength of this book is to suggest what to ask for when starting up a new service and to make the reader aware of what a good service should look like, even if local factors and the ‘Credit Crunch’ mean a much leaner workforce in many areas. The roles of the psychiatrist, speech and language therapist, occupational therapist, nurse and social worker working in a team for children with learning disabilities are described. Sometimes these chapters become rather vague and theoretical, even verging on the platitudinous. Others, in particular the sections on nursing and occupational therapy, give a good sense of what these jobs involve and what practitioners can be expected to do as part of the multidisciplinary team. Another useful section is that on multiagency working, which prepares clinicians for some of the difficulties as well as the positive aspects of working with other disciplines.

The Toolkit is a beautifully presented volume (with a bright orange cover for easy location). Produced by RCPsych Publications in collaboration with the National CAMHS Support Service 2009, the text is economically yet elegantly written. Under the guise of being practical, the Toolkit is stealthily informative about learning disability. This slim orange book deserves to become a classic text for those working in teams with children and young people with a learning disability, and their families.

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