Autistic spectrum disorder (ASD) is a neuro-developmental disability with multi-systemic impacts. Individuals with ASD without intellectual impairment (DSM-V) or Aspergers (DSM-IV) are often particularly vulnerable to mental health problems such as anxiety disorders including social phobia and generalised anxiety disorder, depressive disorders and psychosis. Adults with ASD without intellectual impairment suffer higher rates of physical and psychiatric morbidity, display a poorer ability to engage with treatment and have a lower chance of recovery compared with the general population. It is widely acknowledged that adults with suspected ASD without intellectual impairment and co-morbid mental health problems are often not best supported through adult mental health services and often require more tailored supports. This review seeks to (a) increase awareness in the area of undiagnosed cases of ASD without intellectual impairment in adult mental health settings and (b) highlights the importance of identifying this population more efficiently by referring to best practice guidelines. The value of future research to examine the benefit of having a team of specialist staff within adult mental health teams who have received ASD training and who are supported to work with the ‘core difficulties’ of ASD is discussed and a model for the same is proposed. It is proposed that a specialist team could form a ‘hub’ for the development of expertise in ASD, which when adequately resourced and funded could reach across an entire region, offering consultancy and diagnostic assessments and interventions.

Background: Previous studies have demonstrated that acceptance and commitment therapy (ACT) is effective for depression and may be useful for complex transdiagnostic clients. Aims: To conduct a preliminary evaluation of whether ACT is feasible and effective when delivered by psychologists and non-psychologists for complex clients in a National Health Service (NHS) community mental health service for adults. Method: Staff were trained in ACT and conducted one-to-one therapy with clients. Measures on general mental health, depression, fusion and values were given pre-therapy, post-therapy and at 3-month follow-up. Results: Standardized measures showed significant improvements post-therapy for global mental health, depression, cognitive fusion and values post-treatment. These were partially maintained at follow-up and remained after an intent-to-treat analysis. There were no differences in outcomes between psychologists and non-psychologists. Conclusions: ACT may be delivered effectively with limited training for complex cases in secondary care, though further research is needed.

The emergence of a new youth mental health paradigm has challenged how we think about the provision of mental health care for adolescents and young adults. This editorial tracks the origins of this new paradigm within the field of mental health both internationally and in Ireland.

Objectives: This study aims to investigate the prevalence of neuropsychological disorders in a non-specialist clinical psychology service in adult mental health service and also to explore the existence of neuropsychological symptoms in those subjects having psychiatric disorders.

Method: The yearly data of new referrals from the psychology register and record files of the patients was collected for this purpose and subsequently analysed. The two content scales of MMPI-2, ie. HEA2 and HEA3 were administered and scored.

Results: The results indicate that neuropsychological disorders were the second major referral source during this period and a significant difference (p = 0.001) was found between the scores of HEA-2 and HEA-3, which suggest that the subjects reported more neuropsychological symptoms than symptoms of general health concern during their initial routine psychological assessment.

Conclusion: There is consistency in our findings regarding the questions raised in this study which indicates a prevalence of neuropsychological disorders in adult mental health settings. It also indicates a high rate of neurological symptoms in psychiatric patients with psychiatric disorders.