The Role of Integrated Services in the Care of Children and Young People with Neurodevelopmental Disorders and Co-Morbid Mental Health Difficulties: An International Perspective

Children and Young People (CYP) affected by Neurodevelopmental, Emotional, Behavioural and Intellectual Disorders (NDEBIDs) such as Attention Deficit and Hyperactive Disorder (ADHD) and Autism Spectrum Disorder (ASD) are at increased risk of other Mental Health (MH) difficulties such as anxiety and depression. Therefore, they require comprehensive and holistic services to meet their complex needs. However, many countries still offer them disjointed services involving different healthcare providers and professionals each looking at only one aspect of the CYP’s needs. To address this problem, the framework of “Integrated Care” is recommended as a template for providing comprehensive and joined-up care to meet the complex needs of these CYP with NDEBIDs and MH difficulties. This chapter aims to explore integrated care. It outlines the adverse impacts of disjointed care including: unnecessary multiple referrals, inefficient multiple assessments, delays in accessing required assessment and treatment, frustration and distress for affected CYP and their families and conflicts among professionals. Identified barriers to integrated care include problems with health planning, limited evidence-base, inter-professional difficulties related to different training and professional cultures and mental health stigma. The chapter highlights the benefits of integrated care including user satisfaction, the shortened path to point of care, systemic efficiencies and improved professional relationships. Finally, the chapter discusses the following desirable characteristics of integrated care: joint care commissioning, adequate ring-fenced funding, strategic leadership and planning, cross-training for professionals and good adherence to evidence-based protocols. Perspectives from Low and Middle-Income Countries (LMICs) were also discussed to acknowledge the international nature of the problem.

Keywords: Adolescent, Children, child-health services, Co-morbidities, Holistic services, Integrated care, Mental-health difficulties, mental-health services, Neurodevelopmental disorders, Paediatric services, young people.