6476 The assessment of emotional and mental health problems in children with cerebral palsy: a service evaluation

Objectives Routine practice in our child development centre does not currently include formal screening for mental health problems in children with cerebral palsy (CP). NICE, however, advises using validated tools to assess for mental health problems in children with CP.¹ We conducted a service evaluation project to determine whether this is an unmet need for our patients. More specifically, we planned to: determine the proportion of children with CP attending our school-age motor clinic who also experience mental health problems determine whether the use of the Strengths and Difficulties Questionnaire (SDQ) is welcomed by our patients, their parents and our staff. Methods SDQs were provided to all families of patients with CP invited to an outpatient appointment in our school-age motor clinic over a one-year period. 25 questionnaires were completed; 24 were suitable for analysis. Of these, 52.2% related to 5 – 11 years old patients and 47.8% related to 12 – 17 years old patients. The male to female ratio was 14 to 10. Results Within our sample, more patients were experiencing high to very high difficulties with their mental and emotional health than in the UK community sample upon which the SDQ is based. Comparing our sample with the UK community sample, 34.8% vs 5% scored 'very high'; 8.7% vs 5% scored 'high', 0% vs 10% scored 'slightly raised' and 56.5% vs 80% scored 'close to average' (see figure 1). Overall, 43.5% of the patients in our sample experienced high or very high difficulties with mental and emotional health. Parents expressed gratitude for having been asked about this aspect of their children's lives and commented that this is an area which is frequently overlooked with the focus usually being their child's physical skills. Staff explained they often do not have time to address all areas covered by the SDQ and felt it allowed them to screen for areas of concern whilst normalising discussions around mental and emotional health. Conclusion Almost 1 in 2 of the children with CP attending our school-age motor clinic experience difficulties with their mental and emotional health. This highlights a previously unidentified need. In response, we plan to screen every patient attending the clinic and to offer a resource package to those experiencing difficulties. We aim to use this service evaluation to advocate for access to on-site clinical psychology support, with an agreed referral pathway for the most severely affected patients. Reference NG62. Cerebral palsy in under 25s: assessment and management. National Guideline Alliance (UK). London: National Institute for Health and Care Excellence (NICE); January 2017.