“When other people try to understand”: exploring the experiences of people with intellectual disabilities, who also have mental health problems

2020 ◽  
Vol 14 (3) ◽  
pp. 91-101
Author(s):  
Sasha Martine Mattock ◽  
Kieron Beard ◽  
Amy Baddeley

Purpose Recent guidelines from the National Institute of Health and Care Excellence highlight that service users (SUs) with intellectual disabilities and co-occurring mental health problems rarely get the opportunity to share their experiences of mental health services. Over the past 20 years, policy documents have stated that these individuals (SUs) must be included in decisions about their care. Research suggests that often this is not the case. Therefore, this paper aims to create a space for SUs to share their experiences of mental health services, and what they found helpful. Design/methodology/approach A focus group was held with five SUs, two psychologists and two researchers. The audio recording of the discussion was transcribed and analysed using thematic analysis. Findings Three main themes were identified, namely, “relationships with others”, “inclusion and communication” and “challenges”. This focus group highlighted that although some SUs felt supported, they reported having little control in their lives and wanted to be listened to. Research limitations/implications Including a SU in the planning and facilitation of the focus group would have made this research more inclusive. Practical implications The implications of this research suggest that by listening to and involving SUs and developing more person-centred services, recovery rates may increase as the services provided would be more targeted. Originality/value Very little research has previously been conducted to explore SUs’ experiences. This paper highlights the value of being heard and the knowledge that is often lost if the authors do not take the time to listen to the people for whom a service is designed.

2014 ◽  
Vol 18 (1) ◽  
pp. 35-44 ◽  
Author(s):  
Catherine Conchar ◽  
Julie Repper

Purpose – A systematic review of the literature on “wounded healers” was undertaken to identify, define and interpret the term and its application within the mental health environment. The paper aims to discuss these issues. Design/methodology/approach – Eight key medical/social sciences databases were interrogated. In total, 835 papers were identified in the systematic database search and abstracts were obtained for each to determine whether they met the inclusion criteria. In total, 237 sources were retrieved for critical reading, to assess relevance and value to the review, and 125 documents were subsequently included. Through thematic analysis a number of themes and sub themes were identified Findings – The archetypal image of the wounded healer originates in ancient mythology and crosses many cultures. There are many interpretations and applications of the belief that having healed their own wounds a person is in a better position to heal others, however, the evidence to support this is not so robust. Of more direct relevance to contemporary practice are reports of supporting staff with mental health problems to make a contribution to mental health services, most recently through the employment of peer support workers. Originality/value – As peer support workers are increasingly being employed in mental health services, it is helpful to consider the many existing staff who bring personal experience of mental health problems. This paper explores the evidence that their lived experience makes a difference to the way that they work and considers their employment support needs.


2017 ◽  
Vol 10 (1) ◽  
pp. 68-80 ◽  
Author(s):  
Madeleine Claire Valibhoy ◽  
Josef Szwarc ◽  
Ida Kaplan

Purpose The purpose of this paper is to examine barriers to accessing mental health services, from the perspective of young people of refugee background who have been service users, and to suggest strategies to improve access to mental health services. Design/methodology/approach A qualitative study was conducted with 16 young people (aged 18-25), who had been refugees and who had attended mental health professionals in Australia. Interview transcripts were analysed thematically to examine participants’ perspectives on what hinders initial access to mental health services. Findings Stigma about mental health problems was particularly prominent. Many believed a high level of disturbance was the threshold for entering services, and for some there was no knowledge of such services’ existence. Options for assistance other than mental health services were often preferred, according to young people’s explanatory models. Apprehension was expressed that sessions would be uncomfortable, distressing or ineffective. The desire to be self-reliant functioned as a further barrier. Finally, structural obstacles and social exclusion deterred some young refugees from accessing services. Practical implications Implications include the need for service providers to be equipped to provide culturally sensitive, responsive services that ideally offer both practical and psychological assistance. Potential referrers, including health professionals and community leaders, could facilitate increased access if trained to recognise and address barriers. Finally, findings indicate potential content for awareness-raising initiatives for young refugees about mental health problems and services. Originality/value This paper is original in its sample, method, topic and findings; being drawn from the first known qualitative research exploring views of young mental health service users who have been refugees about barriers to accessing mental health services.


2018 ◽  
Vol 12 (3/4) ◽  
pp. 91-98 ◽  
Author(s):  
Bhathika Perera ◽  
Ken Courtenay

Purpose Services for people with intellectual disabilities in the UK have evolved over the years from hospital-based care to more community provision. There are multiple reasons for these changes, however, often it was due to changes in social policy or following a scandal in provision. The paper aims to discuss these issues. Design/methodology/approach Providing services to meet the health and social care needs of people with intellectual disabilities is well-established in the four countries of the UK with support from legislation. There are often specialist mental health and social care teams. Dedicated professionals work with people with intellectual disabilities who experience mental health problems with a focus on support in the community. A range of services for children and adults and for offenders exist across the UK that often vary in composition and structure. Findings The challenges in providing mental health services for children and adults with intellectual disabilities in the future include recruitment and training of the workforce with the remit of enhancing community support and reduced in-patient care. Practical implications This paper helps the reader to understand how ID mental health services are organised in the UK. Originality/value This paper gives a summary of the ID mental health services in the UK. Even though there are various papers looking at different aspects of mental health services for people with ID in the UK, this paper brings all that information together to help reader get a better understanding of the mental health services for people with ID.


Author(s):  
Owen Barr ◽  
Bob Gates

This chapter has a strong emphasis on promoting mental health and emotional well-being. It also recognizes that people with intellectual disabilities may develop mental health problems similar to, but perhaps more frequently than, people who do not have intellectual disabilities. This chapter considers what emotional well-being is, factors contributing to mental health, and the importance of assertiveness. It then explores how to support people with intellectual disabilities to access general primary, secondary, and tertiary mental health services, before giving specific consideration to anxiety, psychotic and organic disorders, dementia, psychopathology, autistic spectrum disorders, self-harm, substance misuse, and the challenges to emotional well-being that may arise from the experience of bereavement.


2014 ◽  
Vol 8 (6) ◽  
pp. 381-389 ◽  
Author(s):  
Nancy J. Razza ◽  
Laura Schwartz Dayan ◽  
Daniel Tomasulo ◽  
Michelle S. Ballan

Purpose – The purpose of this paper is threefold: to document the relationship between intellectual disability (ID) and psychopathology; to raise awareness of the ongoing lag in professional training for psychologists in the area of mental health treatment for people with intellectual disabilities; and, to provide recommendations for advancing professional education and, ultimately, adequate mental health treatment availability for people with intellectual disabilities. Design/methodology/approach – The paper reviews the literature on prevalence of mental health problems in people with intellectual disabilities. At the same time, the paper reviews the training of psychologists relative to the burgeoning growth in awareness of the mental health needs of people with intellectual disabilities. Findings – The paper concludes that ID is a significant risk factor for psychopathology. In addition, the paper concludes that the education of psychologists regarding the mental health needs of people with intellectual disabilities is insufficient. The authors document the need for incorporating research and treatment advances related to intellectual disabilities and mental health into to the professional training of psychologists. The paper also describe the potential this training holds for improving both the lives of people with intellectual disabilities and the overall competence of psychologists. Practical implications – This paper provides a literature-based rationale for the need to include education in the mental health needs of people with intellectual disabilities into the general training of mental health professionals. In addition, it provides specific recommendations for how such training can be incorporated into graduate psychology programs. Originality/value – This paper provides mental health professionals with a review of the growth in understanding of the enormous, unmet mental health needs of people intellectual disabilities, and of the critical role of ID in development of mental health problems. Moreover, this paper builds the case for an important revision in the training of psychologists to include competence in understanding and treating mental health problems across the full spectrum of intellectual functioning.


2017 ◽  
Vol 12 (4) ◽  
pp. 215-223 ◽  
Author(s):  
Penelope Jane Standen ◽  
Adam Clifford ◽  
Kiran Jeenkeri

Purpose The purpose of this paper is to provide information for non-specialists on identifying the characteristics, assessment and support needs of people with intellectual disabilities (ID) accessing mainstream services. Design/methodology/approach A review of relevant policy and research literature is supplemented with observations from the authors’ own experience of working in mental health services for people with ID. Findings With change in provision of services the likelihood of mainstream staff encountering someone with ID will increase. However, information on whether a person has ID or their level of ID is not always available to professionals in acute mental health services meeting an individual for the first time. Reliance on observational and interview-based assessments can leave people with ID vulnerable to a range of over- and under-diagnosis issues. This is as a result of difficulties with communication and emotional introspection, psychosocial masking, suggestibility, confabulation and acquiescence. For people with poor communication, carers will be the primary source of information and their contribution has to be taken into account. Practical implications Knowing or suspecting an individual has ID allows staff to take into account the various assessment, diagnosis and formulation issues that complicate a valid and reliable understanding of their mental health needs. Awareness about an individual’s ID also allows professionals to be vigilant to their own biases, where issues of diagnostic overshadowing or cognitive disintegration may be important considerations. However, understanding some of the practical and conceptual issues should ensure a cautious and critical approach to diagnosing, formulating and addressing this population’s mental health needs. Originality/value This synthesis of a review of the literature and observations from the authors’ experience of working in mental health services for people with ID provides an informed and practical briefing for those encountering people with ID accessing mainstream services.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jonathan Ee ◽  
Jan Mei Lim ◽  
Biza Stenfert Kroese ◽  
John Rose

Purpose This study aims to explore the experiences of people with intellectual disabilities in Singapore receiving inpatient mental health treatment. To date, there has not been any research that examines the views and experiences of this population in Singapore. The research examines how the participants view their mental health problems and their experiences of the services they received. Design/methodology/approach A qualitative design was chosen to address the research question. Six adult men with intellectual disabilities were recruited from the tertiary hospital and interviewed. The transcripts of these interviews were analysed using interpretative phenomenological analysis. Findings Four super-ordinate themes were identified; awareness of mental health problems; yearn for a life outside the ward; interacting with other people and finding purpose. Originality/value The participants reported that they struggled with being segregated from their families and communities following an inpatient admission. They were able to report on the emotional difficulties that they experienced and hoped to find employment after their discharge from the hospital. They talked about reconstructing their self-identity and forming friendships to cope with their hospital stay. This research is one of its kind carried out in a non-western society and the findings are discussed in the light of how mental health professionals can best support people with intellectual disabilities during their inpatient treatment.


Author(s):  
N. Crowley ◽  
H. O’Connell ◽  
M. Gervin

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.


2019 ◽  
Author(s):  
Bethany Cliffe ◽  
Abigail Croker ◽  
Megan Denne ◽  
Jacqueline Smith ◽  
Paul Stallard

BACKGROUND Insomnia in adolescents is common, persistent, and associated with poor mental health including anxiety and depression. Insomnia in adolescents attending child mental health services is seldom directly treated and the effects of digital CBTi on the mental health of adolescents with significant mental health problems is unknown. OBJECTIVE This paper reports an open study assessing the feasibility of adding supported online CBT for insomnia to the usual care of young people aged 14-17 years attending specialist child and adolescent mental health services. METHODS Thirty-nine adolescents aged 14-17 attending specialist child and adolescent mental health services with insomnia were assessed and offered digital CBTi. The digital intervention was Sleepio, an evidence based, self-directed, fully automated CBTi that has proven effective in multiple randomized controlled trials with adults. Self-report assessments of sleep (Sleep Condition Indicator, Insomnia Severity Scale, online sleep diaries), anxiety (Revised Child Anxiety and Depression Scale) and depression (Mood and Feelings Questionnaire) were completed at baseline and post-intervention. Post-use interviews assessed satisfaction with digital CBTi. RESULTS Average baseline sleep efficiency was very poor (52.9%) with participants spending an average of 9.6 hrs in bed but only 5.1 hrs asleep. All scored <17 on the Sleep Condition Indicator with 36/39 (92.3%) scoring ≥15 on the Insomnia Severity Scale, suggesting clinical insomnia. 36 (92.3%) scored ≥ 27 on the Mood and Feelings Questionnaire for major depression and 20 (51.3%) had clinically elevated symptoms of anxiety. The majority (76%) were not having any treatment for their insomnia, with the remaining 24% receiving medication. Sleepio was acceptable with 77% (30/39) activating their account and 67% (21/30) completing the program. Statistically significant pre-post improvements were found in weekly diaries of sleep efficiency (p=.005) and sleep quality (p=.001) and on measures of sleep (SCI; p=.001: ISI; p=.001), low mood (MFQ; p=.024) and anxiety (RCADS; p=.015). Satisfaction was high; with 89% finding Sleepio helpful, 94% would recommend it to a friend with 39% expressing a definite preference for a digital intervention. CONCLUSIONS Our study has a number of methodological limitations, particularly the small sample size, absence of a comparison group and follow-up assessment. Nonetheless, our findings are encouraging and suggest that digital CBTi for young people with mental health problems might offer an acceptable and an effective way to improve both sleep and mental health. CLINICALTRIAL N/a


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