#MHNR2020 episode 01 - Community mental health care - Elissa Thompson Presentation

Current evidence and care provision for adult patients presenting with autistic experience and a background of complex trauma: A scoping review. Background People who use community mental health services presenting with difficulties associated with an autistic experience often have a background of complex trauma. While someone presenting in this way may often be labelled by services with a BPD (Borderline Personality Disorder) diagnosis, their autistic experience is often never assessed or recognised. Evidence suggests there is often an overlap; individuals may experience increased complexity, risk and reduced quality of life (Dudas et al 2017). This raises challenges for care received, especially as current community services are characterised by poor funding, high turnover of staff and limited use of evidence-based practice (Care Quality Commission 2018). Aim: To report on: A: A review of literature and current policy and practice for people presenting with difficulties associated with the autistic experience and a background of complex trauma (often labelled diagnostically as BPD). B: To pull together current knowledge and outline areas requiring more development to improve the evidence base in frontline clinical practice. Sampling Method: Searches conducted via Scopus and Google Scholar Analytical Approach: Narrative/Thematic synthesis Main findings: Two main themes emerged following analysis. The importance of autistic experiences being properly recognised in clinical populations and the importance of the link between complex trauma and development of subsequent symptoms (oven labelled as BPD traits) being better understood. Discussion:The review demonstrated some developments in the understanding around co-morbidity and complexity of however well developed, evidence based and targeted clinical guidelines for frontline staff continue to be limited. Conclusion: An absence of accurate initial formulation, diagnosis or evidence-based guidance means that the individuals in question continue to receive inadequate care and support, with very limited recognition, by services, of the unique challenges faced by people presenting with traits or diagnosis of both conditions. There is an urgency to improve understanding of the needs of this group, to develop care and support with clearer therapeutic interventions underpinned by an evidence base. This will also help to reduce costs and resources, enabling clinicians to work more effectively.