scholarly journals The Mental Health Clustering Tool for people with severe intellectual disability

2012 ◽  
Vol 36 (12) ◽  
pp. 454-458 ◽  
Author(s):  
Vishwa Radhakrishnan ◽  
Kevin Smith ◽  
Jean O'Hara
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
Community Mental Health ◽  
Learning Disability ◽  
Rating Scales ◽  
Disability Services ◽  
Clinical Implications ◽  
Current Form ◽  
Severe Intellectual Disability ◽  
Integrated Mental Health

Aims and methodWe assessed 92% (117/127) of the patients in our community mental health learning disability team using the Mental Health Clustering Tool (MHCT) to establish whether their needs could be captured sufficiently well to enable assignment to a care cluster for payment by results in mental health. We explored the characteristics of those assigned to Cluster 0 to identify how they differed from those who could be assigned to Clusters 1-21.ResultsAs expected, nearly half of the case-load (48%) could not be assigned to any cluster except Cluster 0, the variance cluster, which is used when the needs of patients cannot be captured by the current 21 care clusters but a service is, or will be, provided.Clinical implicationsThe MHCT in its current form does not adequately capture the needs of people with more severe intellectual disability. An integrated mental health and learning disability clustering tool is in development. This is expected to include new rating scales and new clusters, however until the development is completed and validated it will not be possible to implement payment by results in mental health in learning disability services.

scholarly journals Psychiatry of learning disability – a future with mental health?

2002 ◽  
Vol 26 (8) ◽  
pp. 299-301 ◽  
Author(s):  
R. Alexander ◽  
A. Regan ◽  
S. Gangadharan ◽  
S. Bhaumik
Keyword(s):  
Mental Health ◽  
Learning Disability ◽  
Social Services ◽  
Service Provision ◽  
Postal Survey ◽  
Clinical Implications ◽  
Current Management ◽  
Process Of Change ◽  
Management Changes ◽  
Integrated Mental Health

Aims and MethodA postal survey was sent to all consultants in the psychiatry of learning disability from four English regions. Their views on job satisfaction, their core roles and the management re-structuring of services were elicited.ResultsThe proportion agreeing or strongly agreeing with each management option was 79% for integrated mental health–learning disability trusts, 61% for specialist learning disability trusts, 47% for care trusts, 10% for primary care trusts and 5% for social services. Only 34% felt consulted or able to influence the process of change and only 33% were satisfied with the current management changes within their trust but 67% were satisfied overall with their jobs.Clinical ImplicationsManagement from integrated mental health–learning disability trusts is the most preferred option for psychiatrists in learning disability. A large number of consultants, though otherwise satisfied with their jobs, feel excluded or unable to influence the current changes in management structures. A model of integrated service provision in line with the government's learning disability strategy is presented.

scholarly journals Use of the HoNOS–LD in identifying domains of change

2010 ◽  
Vol 34 (8) ◽  
pp. 322-326 ◽  
Author(s):  
Bradley Hillier ◽  
Lucy Wright ◽  
Andre Strydom ◽  
Angela Hassiotis
Keyword(s):  
Mental Health ◽  
Learning Disabilities ◽  
Learning Disability ◽  
Daily Living ◽  
Patient Admission ◽  
Disability Services ◽  
Patient Treatment ◽  
Clinical Implications ◽  
State Behaviour ◽  
Indicator Data

Aims and methodTo analyse clinical outcome indicator data from the Health of the Nation Outcome Scales for People with Learning Disabilities (HoNOS-LD) in adults with intellectual disability admitted to mental health wards during a 19-month period; and to identify clinically relevant domains of change associated with in-patient admission.ResultsSignificant improvements were found in mental state, behaviour and social functioning. Improvements were also found in cognition and activities of daily living.Clinical implicationsThe HoNOS-LD is a useful tool for measuring clinical outcomes in several relevant domains and guiding in-patient treatment in learning disability psychiatry. It may also provide a currency for payment-by-results and influence the commissioning of learning disability services.

scholarly journals Genetic testing of adults with intellectual disability

2012 ◽  
Vol 36 (11) ◽  
pp. 409-413 ◽  
Author(s):  
Jana de Villiers ◽  
Mary Porteous
Keyword(s):  
Intellectual Disability ◽  
Genetic Testing ◽  
Learning Disability ◽  
Genetic Diagnosis ◽  
Disability Services ◽  
Clinical Implications ◽  
Clinical Genetics ◽  
Genetic Abnormality ◽  
Structured Interviews ◽  
Health Boards

MethodPatients known to learning disability services in two health boards in southeast Scotland were cross-matched with the patients tested at the Western General Hospital in Edinburgh. Those with a positive genetic diagnosis were identified. Semi-structured interviews were conducted with senior learning disability psychiatrists and clinical genetics consultants.ResultsOf the 3323 patients with intellectual disability across both health boards, 41% have had genetic tests and 6% have an identified genetic abnormality as the cause for their intellectual disability. Of the 1349 patients who have been tested, a genetic abnormality was found in 14%. Psychiatrists named several benefits to genetic testing, but they also highlighted a number of non-medical reasons for not testing adults with intellectual disability.Clinical implicationsIdentifying genetic aetiology in intellectual disability has a number of benefits. Our study would indicate that genetic diagnoses are being missed due to a lack of genetic testing in this patient group. Adult learning disability services need to consider increasing genetic testing.

scholarly journals Early detection of antipsychotic side-effects

1999 ◽  
Vol 23 (11) ◽  
pp. 657-660 ◽  
Author(s):  
Robert Chaplin ◽  
Julie Gordon ◽  
Tom Burns
Keyword(s):  
Mental Health ◽  
Side Effects ◽  
Community Mental Health ◽  
Early Detection ◽  
Rating Scales ◽  
Drug Dose ◽  
Clinical Implications ◽  
Detection Rates ◽  
Before And After ◽  
Antipsychotic Side Effects

Aims and methodsStaff from five community mental health teams (CMHTs) were trained to use structured rating scales for akathisia, tardive dyskinesia and Parkinsonism. Detection rates of these side-effects were compared for the six months before and after the intervention.ResultsFifty-seven per cent of the target professionals participated, screening 200 (52%) eligible patients. This resulted in significant increases in the recording of all three side-effects as positive but no increase in their formal diagnosis.Clinical implicationsDetection rates of these side-effects can be increased to those predicted by research with significant reductions in drug dose and non-adherence and without clinical deterioration.

scholarly journals The impact of suicide on community mental health teams: findings and recommendations

2002 ◽  
Vol 26 (2) ◽  
pp. 50-52 ◽  
Author(s):  
Stuart Linke ◽  
Jenny Wojciak ◽  
Samantha Day
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Adverse Effects ◽  
Clinical Implications ◽  
Professional Lives ◽  
Patient Suicide ◽  
Personal Impact ◽  
Sources Of Support ◽  
Team Functioning ◽  
The Impact

Aims and MethodThe study investigated the personal impact of patient suicides on the members of community mental health teams and the sources of support utilised for coping with adverse effects.ResultsForty-four questionnaires were returned. Eighty-six per cent of staff reported having had at least one patient suicide, with an average of 4.2 suicides. The majority of staff reported that patient suicides had significant adverse effects on their personal and professional lives. Some of the effects were long-lasting (greater than 1 month). Staff found that peer support, reviews, dedicated staff meetings and support from senior colleagues were of most value.Clinical ImplicationsStaff require skilled and dedicated support following a patient suicide in order to minimise its detrimental effects on personal, professional and team functioning.

scholarly journals Service provision in Scotland for people with an intellectual disability who have, or are at risk of developing, dementia

Dementia ◽  
2018 ◽  
Vol 19 (3) ◽  
pp. 736-749 ◽  
Author(s):  
Karen McKenzie ◽  
Dale Metcalfe ◽  
Amanda Michie ◽  
George Murray
Keyword(s):  
At Risk ◽  
Intellectual Disability ◽  
Learning Disability ◽  
Service Provision ◽  
Disability Services ◽  
Health Board ◽  
Common Elements ◽  
Online Questionnaire ◽  
Community Learning ◽  
Direct Assessment

This research aimed to identify current national provision by health services in Scotland in relation to proactive screening and reactive assessment for people with an intellectual disability in Scotland who have, or are at risk of developing, dementia. Staff from 12 intellectual disability services, representing the 11 health board areas in Scotland, completed an online questionnaire which asked about proactive screening and reactive assessment for people with intellectual disability who had, or were at risk of developing, dementia as well as suggested areas for improvement. All of the areas provided services for people with intellectual disability who have, or are at risk of developing, dementia, but differed as to whether this was reactive, proactive or both. Nine services offered intervention following diagnosis. The most common elements used across both proactive screening and reactive assessment were conducting a health check, using a general dementia questionnaire designed for people with an intellectual disability and direct assessment with the person. Clinical psychology and community learning disability nurses were the professions most likely to be involved routinely in both proactive screening and reactive assessments. The psychometric properties of the most commonly used assessments of cognitive and behavioural functioning were mixed. The areas of improvement suggested by practitioners mainly related to ways of improving existing pathways. This research represents the first step in providing an overview of service provision in Scotland. There was some inconsistency in relation to the general and specific components which were involved in proactive screening and reactive assessment. Implications for service provision are discussed.

scholarly journals The case for removing intellectual disability and autism from the Mental Health Act

2019 ◽  
Vol 215 (5) ◽  
pp. 633-635
Author(s):  
Sheila Hollins ◽  
Keri-Michèle Lodge ◽  
Paul Lomax
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
Health Services ◽  
Mental Disorder ◽  
Learning Disability ◽  
Mental Illnesses ◽  
Mental Health Act ◽  
Definition Of ◽  
Serious Mental Illnesses

SummaryIntellectual disability (also known as learning disability in UK health services) and autism are distinct from the serious mental illnesses for which the Mental Health Act is designed to be used. Their inclusion in the definition of mental disorder is discriminatory, resulting in unjust deprivations of liberty. Intellectual disability and autism should be excluded from the Mental Health Act.Declaration of interestNone.

Descriptive study of patients with intellectual disability attended in a community mental health care center

2017 ◽  
Vol 41 (S1) ◽  
pp. S599-S600
Author(s):  
S. Oller Canet ◽  
E. Pérez Sánchez ◽  
L. Alba Pale ◽  
E. Mur Mila ◽  
B. Samsó Buixareu ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Intellectual Disability ◽  
Community Mental Health ◽  
Mental Health Care ◽  
Aggressive Behavior ◽  
Psychotic Disorders ◽  
Care Center ◽  
Community Mental Health Care ◽  
Health Care Center

IntroductionThe rate of mental illness among people with intellectual disability is at least 2.5 times higher than in the general population [1].ObjectiveTo describe the clinical and sociodemographic characteristics of all patients with intellectual disability treated in a community mental health care center (CMH) located in a city of 120,000 inhabitants on the outskirts of Barcelona with a high poverty index.MethodsDocuments and patient records were reviewed. Clinical, sociodemographic and other treatment data of patients with intellectual disability treated at the CMH were collected.ResultsThe sample consisted of 118 patients. Mean age: 39.5 (SD: 15), 54% men. 92% single and 23.7% legally incapacitated. 46.6% never completed basic education and 44.1% completed primary school. Employment status: 14.4% unemployed, 14.4% currently active, and 50% pensioned. Patients living mainly with their family (parents:) 86%. 68.6% of patients showed aggressive behavior, but the rate of hospital psychiatric admissions was low (mean: 1.1 (SD: 2.3)). Organic comorbidity: 44.9%. Functionality measured with GAF mean: 45 (SD: 12). Level of intellectual disability was mostly mild (62%). Psychiatric diagnoses were: psychotic disorders: 49.25%, affective disorders: 6.8%, personality disorder: 3.4%, Obsessive-compulsive disorder: 3.4%, autism: 11.9% and other diagnoses: 37.3%. Patients treated with anti-psychotics: 78.8%, anti-depressants: 40.7%, and mood stabilizers: 70.5%.ConclusionsIntellectually disabled patients from our sample showed high comorbidity with psychotic disorders, were highly medicated and often exhibited aggressive behavior.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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