scholarly journals Working together: making the case for integrated forensic services for people with intellectual disabilities

2015 ◽  
Vol 6 (3/4) ◽  
pp. 204-210 ◽  
Author(s):  
Kenneth MacMahon ◽  
Ricky McClements
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
Intellectual Disabilities ◽  
Integrated Model ◽  
Content Type ◽  
Fully Integrated ◽  
Forensic Service ◽  
Working Together ◽  
People With Intellectual Disabilities ◽  
Integrated Service

Purpose – There is a general consensus that healthcare for people with intellectual disabilities should be provided by multi-disciplinary teams. Within a forensic setting, recommendations are often made for separate or “parallel” forensic teams, operating independently of generic mental health or intellectual disability teams. An alternative to this model is an “integrated” service, where specialist forensic clinicians work within the general intellectual disability service, to provide support for clients with forensic needs. For clients with intellectual disabilities and forensic needs, there may be advantages to providing access to a wider multi-disciplinary team, through the application of an integrated model. The purpose of this paper is to illustrate the working of an integrated forensic service within a learning disability team, to identify positive aspects of this model, and how potential shortcomings may be overcome. Design/methodology/approach – Literature review, description of service outline with case example. Findings – Although some studies have compared parallel and integrated forensic models within mental health services, there are no evaluations that compare models of forensic services for individuals with intellectual disabilities. However, specific advantages of an integrated model may include availability of multi-disciplinary clinicians, development of forensic skills across wider groups of clinicians, reduction in stigma and avoidance of delay in transfer of care between services. In addition, in areas with smaller populations, parallel services may not be feasible due to low case numbers. Originality/value – There has been no formal evaluation of parallel vs integrated forensic services within an intellectual disability setting. However, the authors describe a fully integrated service and suggest means by which the potential shortcomings of an integrated model may be overcome.

scholarly journals Are we training psychiatrists to develop skills in intellectual disability psychiatry? Current European context and future directions

2020 ◽  
Vol 63 (1) ◽  
Author(s):  
Marisa Casanova Dias ◽  
Bhathika Perera ◽  
Florian Riese ◽  
Livia De Picker ◽  
Mariana Pinto da Costa ◽  
...  
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
Mental Health Services ◽  
Health Services ◽  
Intellectual Disabilities ◽  
Psychiatric Disorders ◽  
Psychiatric Training ◽  
Future Directions ◽  
Education And Health ◽  
People With Intellectual Disabilities

Abstract The majority of people with intellectual disabilities (ID) and psychiatric disorders access mainstream mental health services across Europe. However, only 56% of countries provide postgraduate psychiatric training in ID according to a survey across 42 European countries. We explore the challenges of ID training and make recommendations for education and health policymakers.

“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
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Focus Group ◽  
Health Services ◽  
Intellectual Disabilities ◽  
Mental Health Problems ◽  
Health Problems ◽  
Content Type ◽  
The People ◽  
People With Intellectual Disabilities

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.

Mind Matters: a psychoeducation programme for individuals with intellectual disabilities and co-morbid diagnoses of mental disorder

2017 ◽  
Vol 8 (1) ◽  
pp. 34-40 ◽  
Author(s):  
Sarah Ashworth ◽  
Krista Jansen ◽  
Lydia Bullock ◽  
Paul Mooney
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Intellectual Disability ◽  
Personality Disorder ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Intellectual Disabilities ◽  
Psychological Intervention ◽  
Content Type ◽  
Group Members

Purpose The purpose of this paper is to describe a feasibility study into the development and pilot of a psychoeducational group for people with intellectual disability and co-morbid mental disorder (including mental illness and personality disorder) within forensic settings. Design/methodology/approach “Mind Matters”, a psychoeducational programme for people with an intellectual disability and co-morbid mental disorders is a group based programme in a medium secure hospital, adapted and developed to be suitable for people with intellectual disability therapist multidisciplinary approach was key to its development. An open group on a 16-bedded ward for individuals with mild to moderate intellectual disability and co-morbid mental illness was delivered over a six-week period. Findings The group was positively received in pilot by participants and members of the clinical teams. Attendance and engagement of participants were key measures of the success of the programme. In addition to the apparent increased social skills and motivation to engage with future psychological intervention. Practical implications The authors believe that this approach benefitted both the group members and staff on ward, reinforcing strategies for maintaining positive mental health. It also stimulated engagement, discussion about mental disorders including mental illness, personality disorder and intellectual disabilities. Originality/value This paper shows how a psychoeducational approach to mental disorder and mental health in individuals with an intellectual disability is possible, beneficial and well received.

Antipsychotic prescribing for patients with intellectual disabilities and challenging behaviours

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Bushra Elhusein ◽  
Yassin Eltorki ◽  
Oraib Abdallah ◽  
Mohamed El Tahir
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
Best Practices ◽  
Intellectual Disabilities ◽  
Challenging Behaviour ◽  
Prescribing Practices ◽  
Content Type ◽  
Antipsychotic Prescribing ◽  
Challenging Behaviours ◽  
Audit Standards

Purpose Review of antipsychotic prescribing practices, rationale and follow-up using an internationally standardized audit can be an effective tool to encourage and monitor best practices. The purpose of this study is to audit the current prescribing pattern for people with intellectual disabilities and challenging behaviours in Qatar. Design/methodology/approach This study was based on the challenging behaviour management guidelines recommended by the Royal College of Psychiatrists. All current electronic medical records in the Mental Health Service-Hamad Medical Corporation were examined to identify patients with intellectual disabilities who received antipsychotics for challenging behaviour. Demographic variables, such as age, sex and nationality, were collected. In addition, details of psychiatric diagnoses, prescribed psychotropic medications and diagnoses of epilepsy were also collected. For patients who were prescribed antipsychotic medication, the clinical rationale for such medication was collected along with evidence of side effect monitoring to allow performance against the audit standards to be measured. Findings This is the first audit on prescribing practices in people with intellectual disability and challenging behaviour in the state of Qatar. The results of this study regarding the pattern of prescribing practices for patients with intellectual disability and challenging behaviour reflect the limitation in knowledge and experience among non-specialist practitioners within mental health service. The result may be helpful to support the development of specialist service provision to improve the care for such vulnerable group. The result may also help other medical centres and clinicians by providing an improved understanding of possible deviations from the best medical practices. Originality/value This is the first audit on prescribing practices in people with intellectual disability and challenging behaviour in the state of Qatar. The study is also noteworthy as, to the best of the authors’ knowledge, it is one of only a few studies on antipsychotic prescribing for patients with intellectual disability and challenging behaviour in the Middle East; therefore, it will be useful in raising awareness and promoting the best practices in the Middle East region. This study is also among the first few studies that were designed based on the four audit standards by the Royal College of Psychiatrists in this area.

Special needs of adolescents and elderly people with intellectual disability

2012 ◽  
pp. 1878-1883
Author(s):  
Jane Hubert ◽  
Sheila Hollins
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
Intellectual Disabilities ◽  
Special Needs ◽  
Elderly People ◽  
General Rule ◽  
Health Needs ◽  
Social Health ◽  
Mental Health Needs ◽  
People With Intellectual Disabilities

Social health and mental health needs change throughout life, and this chapter highlights those particularly relevant for adolescents and elderly people. As a general rule, people with intellectual disabilities have the same needs as other members of the community, but they may also have additional needs for which they are entitled to extra support.

Mental health services for people with intellectual disability in the United Kingdom

2018 ◽  
Vol 12 (3/4) ◽  
pp. 91-98 ◽  
Author(s):  
Bhathika Perera ◽  
Ken Courtenay
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Intellectual Disabilities ◽  
Social Care ◽  
Community Support ◽  
Content Type ◽  
Health And Social Care ◽  
People With Intellectual Disabilities ◽  
The Uk

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.

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.

Commentary on “The effectiveness of psychodynamic interventions for people with learning disabilities: a systematic review”

2013 ◽  
Vol 19 (1) ◽  
pp. 25-28
Author(s):  
Hilary Brown
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Learning Disabilities ◽  
Intellectual Disabilities ◽  
Family Members ◽  
Direct Care ◽  
Care Staff ◽  
Direct Care Staff ◽  
Content Type ◽  
People With Intellectual Disabilities

Purpose – This paper is a commentary on “The effectiveness of psychodynamic interventions for people with learning disabilities: a systematic review” by Chris James and James Stacey. The purpose of this paper is to illustrate the thesis that standardised ways of evaluating health care interventions may have the inadvertent effect of undermining the case that people with intellectual disabilities should be offered the same opportunities to address their emotional and mental health difficulties as other citizens. Design/methodology/approach – The commentary argues that while the evidence base focuses on the outcomes of orthodox one-to-one interventions, sometimes broader “contextual reformulation” and systemic interventions are called for. However, family- or service-based interventions tend not to feature in studies. Findings – The commentary illustrates these issues by discussing two case studies, which demonstrate how relational issues tend to be unhelpfully focused on the person with intellectual disabilities to the detriment of family members or direct care staff, who may be struggling to make sense of the person's behaviour or distress. Originality/value – The commentary supports the argument put forward in the longer paper and also argues for mental health services to be offered on a non-discriminatory basis to people with intellectual disabilities and to their family members. But it also suggests that one of the additional impacts of service level psychotherapeutic interventions is to re-establish respect for the work of direct care staff whose work is often presented as if it is little more than domestic drudgery when in fact it involves negotiating and responding to people and their issues with great sensitivity and balance.

Involving people with intellectual disabilities in the assessment of healthcare professionals

2014 ◽  
Vol 8 (6) ◽  
pp. 362-369 ◽  
Author(s):  
Sujata Soni ◽  
Ian Hall ◽  
Phill Doulton ◽  
Peter Bowie
Keyword(s):  
Intellectual Disability ◽  
Intellectual Disabilities ◽  
Healthcare Professionals ◽  
Quality Of Healthcare ◽  
Simulated Patients ◽  
Content Type ◽  
Department Of Health ◽  
Potential Benefits ◽  
People With Intellectual Disabilities ◽  
Training Programmes

Purpose – It is widely recognised that people with intellectual disabilities receive a poorer quality of healthcare than their non-disabled counterparts. Training for healthcare professionals in intellectual disability is often scant or non-existent. The purpose of this paper is to explore the usefulness of employing actors with intellectual disabilities as simulated patients in the assessment of trainee psychiatrists. Design/methodology/approach – The development of a structured clinical exam “station” designed to assess the ability of trainee psychiatrists to communicate with a simulated patient played by an actor with an intellectual disability is described. The paper also assesses the potential benefits of this kind of assessment and the experience of actors and examiners taking part in this process. Findings – The station was found to perform well in discriminating between candidates of various abilities and was well received by actors, examiners and observers. The station is now routinely used in the formal assessment of trainee psychiatrists. Practical implications – The use of people with intellectual disabilities in training and assessment appears to be advantageous in terms of improving knowledge, attitudes and skills amongst healthcare professionals and gives increased opportunities for people with intellectual disabilities to undertake valued social roles. Originality/value – Few institutions currently employ actors with intellectual disabilities as simulated patients as part of their training programmes and as a result there is little in the way of literature on this subject. This paper describes an alternative approach to teaching and assessment which falls in line with recommendations from the Department of Health to involve service users in the training of healthcare professionals.

Commentary on “The experiences of Covid-19 ‘lockdown’ for people with a learning disability: results from surveys in Jersey and Guernsey”

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Gemma Rogers
Keyword(s):  
Mental Health ◽  
Intellectual Disabilities ◽  
Design Methodology ◽  
Well Being ◽  
Content Type ◽  
People With Intellectual Disabilities ◽  
Long Term Consequences ◽  
Health And Well Being ◽  
Over Time

Purpose This paper aims to consider the experiences of people with intellectual disabilities in relation to the COVID-19 pandemic and subsequent lockdown restrictions. Design/methodology/approach This commentary reflects on the issues raised by Morris et al., and in the wider literature. Findings Although there have been some benefits to lockdown for people with intellectual disabilities, mainly they have experienced isolation, increased mental health and well-being challenges, difficulty in accessing services, support and adequate adapted information. Originality/value This commentary argues that it is important to continue to capture the experiences of people with intellectual disabilities now and over time to assess the long-term consequences of the pandemic and to design services which are respondent to their needs.

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