Background and aims There is a high burden of mental health (MH) problems among children with epilepsy. The relationship between MH problems and epilepsy is bidirectional with shared risk factors. Our key aims were:

• To determine the prevalence of MH difficulties among the patients of our Secondary Paediatric Epilepsy Service.

• To ascertain if more input from MH services is required within the Secondary Paediatric Epilepsy Service.

• To demonstrate the use of a standardised behavioural screening questionnaire in assessing MH difficulties.

Methods The Strengths and Difficulites Questionnaire (SDQ) was used to screen for those at risk of, or currently experiencing MH problems. We received 86 replies and, following exclusions, 64 patients data was analysed. The patient’s electronic notes were used to determine diagnoses and medications.

Results 56% of patients scored high or very high risk for having or developing MH difficulties. A chi- square test indicated a significant difference (p<0.001) in the proportion of children with epilepsy with clinically significant scores versus the proportion in the community samples. Peer and pro-social subdomains scored in the ‘high’ risk category whilst the other subdomains scored in ‘close to average’ risk. Patients not on anti-epileptic drugs have close to average scores. There is trend towards those on more than 1 Antiepileptic drug having higher scores. Developmental disorder increases that risk of having a high or very high score from 43% to 68%.

Conclusions Our results reflect similar prevalence to that demonstrated in the literature; children with epilepsy have a high risk of developing MH disorders. Our data highlights the need to improve identification, diagnosis, prevention and management of MH problems in children with epilepsy on both a national and local level.