Background: The Supported Discharge Service (SDS) is a model of enhanced care in the community for adolescents after inpatient discharge. Methods: This study comprised the first 20 patients referred to SDS, largely those with delayed discharges. Service use and clinical outcomes were collected and predictors of total contact time were investigated. Results: Significant improvements had been made with SDS. Higher baseline Strengths and Difficulties Questionnaire (SDQ) conduct scores were associated with less contact time. Conclusions: SDS is a feasible model of care. Adolescents with conduct problems may benefit from engagement strategies. Further rigorous evaluation of the model is required. Key Practitioner Message• Hospitalized youth with moderate to severe mental health problems may be cared for in the community by intensive step-down care using the Supported Discharge Service model • SDS is able to provide effective clinical care that both patients and families find useful and acceptable

This study supports previous findings that alcohol and drug use are declining in adolescents in UK. There are different patterns of substance use amongst different ethnic groups; this is important to schools and policymakers planning interventions related to substance use in school-aged children.

Purpose This study aims to builds upon the hypothesis that “gang” offenders have greater mental health vulnerabilities than both the offender and the general population. This study aims to determine whether there is a difference between the mental health difficulties experienced by young people who may be committing offenses or who may be non-offenders while exploring the interplay of conduct disorder (CD). Design/methodology/approach Secondary data analysis was conducted of a cross-sectional survey of 449 young people in two secondary schools and the data was compared to the scores on the strengths and difficulties questionnaire (SDQ). A diagnosis of CD was given to the respondents scoring “abnormal” for conduct on the SDQ and the findings were compared to the total difficulties score of those without a diagnosis of CD. Findings Those committing offenses both alone and within a group setting had significantly higher scores across all domains of the SDQ, indicating the prevalence of inattention and hyperactivity, emotional problems, lower prosocial behaviors and peer problems over other offending groups. The total difficulties scores on the SDQ were significantly higher for the offending groups that had a diagnosis of CD. Originality/value The results suggest that offending patterns are included within the screening for CD subtypes and support the need for further research into tailored interventions that involve multi-agency collaboration. This research offers a new approach to the identification of severe CD with callous and unemotional traits by examining offensive behavior.

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The prevalence of attention deficit and hyperactivity disorder diagnosis appears to have increased in recent years, with much discussion on the subject in the popular press. This article discusses the role of mental health nurses in the management of this often underdiagnosed and undertreated condition in adults, taking account of extended roles such as non-medical prescribers and the recently published clinical guideline by the National Institute for Health and Care Excellence. There is a continued need to support shared decision making, encourage adherence to treatment and reduce the negativity surrounding the use of controlled drugs to manage this condition. Children who have a diagnosis of attention deficit and hyperactivity disorder will generally have had comorbid difficulties considered as part of the diagnosis and treatment plans, with input from education in addition to health and social care. In adulthood, it could be argued that the focus is on managing substance abuse, mood and anxiety disorders, resulting in the diagnosis of attention deficit and hyperactivity disorder being overlooked.