The planning and provision of psychiatric services for adults with intellectual disability

2012 ◽  
pp. 1887-1892
Author(s):  
Nick Bouras ◽  
Geraldine Holt
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
Life Experiences ◽  
Social Competency ◽  
Psychiatric Services ◽  
Behavioural Disorders ◽  
Wide Range ◽  
The World ◽  
Provision Of Services

The functioning of people with intellectual disability (ID) is affected by many factors. As well as their ID, their ability to communicate with others, their social competency, personality, life experiences and circumstances, and their health (including mental health) also influence their behaviour and adjustment. This chapter focuses on the development and provision of services for adults with ID who have additional psychiatric and behavioural disorders. Developments have taken place in various parts of the world in recent years and a wide range of services has emerged.

scholarly journals Health and wellbeing of people with intellectual disability in New South Wales, Australia: a data linkage cohort

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e031624 ◽  
Author(s):  
Simone Reppermund ◽  
Theresa Heintze ◽  
Preeyaporn Srasuebkul ◽  
Rebecca Reeve ◽  
Kimberlie Dean ◽  
...  
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
Health Service ◽  
Service Use ◽  
New South ◽  
New South Wales ◽  
Data Sets ◽  
Psychiatric Admission ◽  
South Wales ◽  
Wide Range

PurposePeople with intellectual disability (ID) experience high rates of physical and mental health problems, while access to appropriate healthcare is often poor. This cohort was established to develop an epidemiological profile related to the health, health service use, disability services, mortality and corrective services records of people with ID.ParticipantsThe cohort contains 92 542 people with ID (40% females) with a median age of 23 years (IQR: 12–43 years) and 2 004 475 people with a neuropsychiatric or developmental disorder diagnosis (50% females) with a median age of 51 years (IQR: 29–73 years) from New South Wales, Australia. The whole sample contains records for 2 097 017 individuals with most data sets spanning financial years 1 July 2001 to 30 June 2016. A wide range of data from linked population data sets are included in the areas of disability, health, corrective services and targeted specialist support services in public schools, Public Guardian and Ombudsman services.Findings to dateThis study includes one of the largest cohorts of people with ID internationally. Our data have shown that the presence of ID is significantly associated with emergency department presentations and psychiatric readmissions after the first psychiatric admission based on a subcohort of people with a psychiatric admission. Adults with ID experience premature mortality and over-representation of potentially avoidable deaths compared with the general population.Future plansWithin the health service system, we will examine different components, that is, inpatient, emergency adult services, children and younger people services and costs associated with healthcare as well as mortality, cause and predictors of death. The neuropsychiatric and developmental disorders comparison cohort allows comparisons of the physical health, mental health and service use profiles of people with ID and those with other neuropsychiatric disorders.

Psychiatry and intellectual disabilities: navigating complexity and context

2017 ◽  
Vol 12 (4) ◽  
pp. 224-236 ◽  
Author(s):  
Jo Jones ◽  
Kiran Jeenkeri ◽  
Peter Cutajar
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
Intellectual Disabilities ◽  
Health Practitioner ◽  
Current Policy ◽  
Content Type ◽  
General Mental Health ◽  
Neurodevelopmental Model ◽  
Wide Range ◽  
Potential Factors

Purpose The paper is a review, for the general adult mental health practitioner, of the issues to consider when managing a mental health presentation of a person with intellectual disability (PWID). The paper aims to discuss these issues. Design/methodology/approach A neurodevelopmental model is outlined to assist practitioners in unravelling the wide range of potential factors relevant to intellectual disabilities (IDs). This includes an emphasis on complexity and interdisciplinary formulation within an individual’s context, and implications of the current policy changes. Findings In practice, managing the mental health of PWID can be challenging within usual mainstream services; there is more to consider than is usual for the general population. Originality/value The paper provides general mental health practitioners with a framework for a greater depth of understanding of the issues involved in the management of people with intellectual disability (ID). This includes discussion of the current policy context in ID, and some of its limitations.

scholarly journals Complementary and alternative medicine contacts by persons with mental disorders in 25 countries: results from the World Mental Health Surveys

2017 ◽  
Vol 27 (6) ◽  
pp. 552-567 ◽  
Author(s):  
P. de Jonge ◽  
K. J. Wardenaar ◽  
H. R. Hoenders ◽  
S. Evans-Lacko ◽  
V. Kovess-Masfety ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Mood Disorders ◽  
Standard Error ◽  
Health Surveys ◽  
Conventional Care ◽  
Behavioural Disorders ◽  
The World

Aims.A substantial proportion of persons with mental disorders seek treatment from complementary and alternative medicine (CAM) professionals. However, data on how CAM contacts vary across countries, mental disorders and their severity, and health care settings is largely lacking. The aim was therefore to investigate the prevalence of contacts with CAM providers in a large cross-national sample of persons with 12-month mental disorders.Methods.In the World Mental Health Surveys, the Composite International Diagnostic Interview was administered to determine the presence of past 12 month mental disorders in 138 801 participants aged 18–100 derived from representative general population samples. Participants were recruited between 2001 and 2012. Rates of self-reported CAM contacts for each of the 28 surveys across 25 countries and 12 mental disorder groups were calculated for all persons with past 12-month mental disorders. Mental disorders were grouped into mood disorders, anxiety disorders or behavioural disorders, and further divided by severity levels. Satisfaction with conventional care was also compared with CAM contact satisfaction.Results.An estimated 3.6% (standard error 0.2%) of persons with a past 12-month mental disorder reported a CAM contact, which was two times higher in high-income countries (4.6%; standard error 0.3%) than in low- and middle-income countries (2.3%; standard error 0.2%). CAM contacts were largely comparable for different disorder types, but particularly high in persons receiving conventional care (8.6–17.8%). CAM contacts increased with increasing mental disorder severity. Among persons receiving specialist mental health care, CAM contacts were reported by 14.0% for severe mood disorders, 16.2% for severe anxiety disorders and 22.5% for severe behavioural disorders. Satisfaction with care was comparable with respect to CAM contacts (78.3%) and conventional care (75.6%) in persons that received both.Conclusions.CAM contacts are common in persons with severe mental disorders, in high-income countries, and in persons receiving conventional care. Our findings support the notion of CAM as largely complementary but are in contrast to suggestions that this concerns person with only mild, transient complaints. There was no indication that persons were less satisfied by CAM visits than by receiving conventional care. We encourage health care professionals in conventional settings to openly discuss the care patients are receiving, whether conventional or not, and their reasons for doing so.

scholarly journals Are specialist psychiatric services losing the PbR race?: commentary on… clustering in mental health payment by results

2014 ◽  
Vol 20 (4) ◽  
pp. 235-236
Author(s):  
Vishwa Radhakrishnan
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
Mental Health Services ◽  
Health Services ◽  
Healthcare Services ◽  
Psychiatric Services ◽  
Short Term ◽  
Specialist Services ◽  
Health Payment

SummaryPayment by results (PbR) is a payment platform for healthcare services. Introduced to acute physical healthcare services in England in 2003–2004, the system has continued to expand and is currently being implemented in acute mental health services. Owing to the variations and complexities of the patients who access specialist psychiatric services, existing clusters do not always accurately capture their needs. The development of PbR tools specific to psychiatric subspecialties is ongoing, but might not be available in the short term. The funding of acute mental health services through PbR might have funding implications for specialist services such as psychiatry of intellectual disability.

scholarly journals The WHO mhGAP Intervention Guide for people with intellectual disability: the Sri Lankan experience

2015 ◽  
Vol 12 (S1) ◽  
pp. S-19-S-23
Author(s):  
Rohit Gumber ◽  
Shweta Gangavati ◽  
Sabyasachi Bhaumik ◽  
Sherva Cooray ◽  
Kiran Purandare ◽  
...  
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
Pilot Project ◽  
World Health ◽  
Sri Lankan ◽  
Treatment Gap ◽  
The World ◽  
Health Gap ◽  
Action Programme ◽  
Health Organization

In recognition of the treatment gap in mental health, the World Health Organization (WHO) Mental Health Gap Action Programme (mhGAP) was launched in 2008 and has proved successful. The paper describes the launch of the first mhGAP intellectual disabilities pilot project in Sri Lanka. It reports on the development of the materials and the key lessons learnt.

scholarly journals Physiotherapy and Mental Health

2019 ◽  
Vol 18 (2) ◽  
pp. 208-214
Author(s):  
Michel Probst
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Healthy Lifestyle ◽  
Scientific Evidence ◽  
Evidence Based ◽  
Appropriate Care ◽  
Wide Range ◽  
The World ◽  
Movement Awareness ◽  
World Confederation

Physiotherapy in mental health care and psychiatry is recognized by the World Confederation for Physical Therapy (WCPT) as a specialty within physiotherapy. Physiotherapy in mental health offers a wide range of interventions in regard of body functions, physical activity, exercises, sensory, body and movement awareness, stress and tense regulation and pain management, based on clinical and scientific evidence-based literature. Additionally, the promotion of a healthy lifestyle and “physio-education” (i.e. the process of providing education and information regarding specific physiotherapy related topics to patients and their family members) should be a responsibility of the physiotherapist. This paper gives a short overview of the interventions in the field of mental health to offer appropriate care to a specific vulnerable but growing group in our society.

Advocating Globally to Shape Policy and Strengthen Nursing’s Influence

2012 ◽  
Vol 17 (1) ◽  
Author(s):  
David Benton
Keyword(s):  
Papua New Guinea ◽  
Healthcare Service ◽  
Life Experiences ◽  
Real Life ◽  
Nursing Profession ◽  
International Council ◽  
Wide Range ◽  
The World ◽  
Service Policies ◽  
Nursing Associations

The International Council of Nurses is a federation of national nursing associations that works to enable nurses to speak with one voice so as to influence health policy and advance the profession of nursing. In this article the author highlights how nurses can advocate for the nursing profession by coordinating nursing actions to develop both public and healthcare-service policies. He addresses issues that are common in many parts of the world and provides examples drawn from real-life experiences that illustrate how nurses in El Salvador, Rwanda, Paraguay, Papua New Guinea, and Iran have worked in their countries to coordinate their actions and advocate for public and/or healthcare service policies within their countries. He concludes by noting that all nurses must do their part and use a wide range of opportunities creatively, and with clarity of intent, to improve the profession and the lives of the millions of people who depend upon us.

scholarly journals Mental Health Reform and Evolution of General Psychiatry in Ontario

2002 ◽  
Vol 47 (7) ◽  
pp. 644-651 ◽  
Author(s):  
John Robert Swenson ◽  
Jacques Bradwejn
Keyword(s):  
Mental Health ◽  
Health System ◽  
Mental Health System ◽  
Health Reform ◽  
Psychiatric Services ◽  
General Hospitals ◽  
Mental Health Reform ◽  
General Psychiatry ◽  
Wide Range ◽  
Community Mental Health Agencies

Objectives: To discuss developments in Ontario mental health reform, describe general psychiatric services in contrast to tertiary services, describe guidelines for the training of general psychiatrists, and suggest what changes may be required to develop an integrated mental health system (IMHS). Method: We review the Ontario government's recent blueprint for mental health reform and the Canadian federal government's document on best practices in psychiatry, in the context of defining general psychiatric services and their relation to tertiary services. From this, we consider the education of general psychiatrists and make suggestions for their training. Results: General psychiatric services correspond to first-line and intensive psychiatric services delivered by community mental health agencies, community psychiatrists, and general hospitals for patients with moderate or serious mental illness. Many suggest that psychiatrists are not being trained to meet the needs of a reformed mental health system. An education program for general psychiatrists should include training in a wide range of community and general hospital settings, work within a multidisciplinary mental health team, and experience working in a shared care model with family physicians. Conclusions: Along with training general psychiatrists better, we must also develop recruitment and payment incentives, which would allow general psychiatrists who are based in the community and general hospitals to work within an IMHS.

scholarly journals The World Health Organization World Mental Health Survey Initiative

2006 ◽  
Vol 15 (3) ◽  
pp. 161-166 ◽  
Author(s):  
Ronald C. Kessler ◽  
Josep Maria Haro ◽  
Steven G. Heeringa ◽  
Beth-Ellen Pennell ◽  
T. Bedirhan Üstün
Keyword(s):  
Mental Health ◽  
World Health Organization ◽  
World Health ◽  
Quality Data ◽  
World Mental Health ◽  
Epidemiological Surveys ◽  
Wide Range ◽  
The World ◽  
Health Organization ◽  
Cross National

AbstractTo present an overview of the World Health Organization World Mental Health (WMH) Survey Initiative. The discussion draws on knowledge gleaned from the authors' participation as principals in WMH. WMH has carried out community epidemiological surveys in more than two dozen countries with more than 200,000 completed interviews. Additional surveys are in progress. Clinical reappraisal studies embedded in WMH surveys have been used to develop imputation rules to adjust prevalence estimates for within- and between-country variation in accuracy. WMH interviews include detailed information about sub-threshold manifestations to address the problem of rigid categorical diagnoses not applying equally to all countries. Investigations are now underway of targeted substantive issues. Despite inevitable limitations imposed by existing diagnostic systems and variable expertise in participating countries, WMH has produced an unprecedented amount of high-quality data on the general population cross-national epidemiology of mental disorders. WMH collaborators are in thoughtful and subtle investigations of cross-national variation in validity of diagnostic assessments and a wide range of important substantive topics. Recognizing that WMH is not definitive, finally, insights from this round of surveys are being used to carry out methodological studies aimed at improving the quality of future investigations.

scholarly journals Current concerns about mental health in Bangladesh

2021 ◽  
Vol 18 (4) ◽  
pp. 77-78
Author(s):  
David Skuse
Keyword(s):  
Mental Health ◽  
Natural Disasters ◽  
Clinical Psychologists ◽  
Wide Range ◽  
The World ◽  
Current Concerns

This month's issue of BJPsych International focuses on Bangladesh, one of the most densely populated countries in the world and geographically vulnerable to a wide range of natural disasters. Mental health has been deteriorating since the COVID-19 crisis, but few psychiatrists and clinical psychologists are available to manage the consequences.

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