Support for people with learning disabilities: promoting an inclusive community

2017 ◽  
Author(s):  
Barbara McIntosh
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Learning Disabilities ◽  
Learning Disability ◽  
Public Spending ◽  
Historical Background ◽  
Financial Constraint ◽  
Future Prospects ◽  
Care And Support ◽  
The Uk

This chapter considers inclusive communities as a form of support for people with learning disabilities (LDs). There are one-and-a-half million people with LDs in the UK. Many of these people believe that a gap exists between UK policy and reality, made worse by recent cuts in public spending. Nevertheless, there has been progress in this area. The chapter first explains what a learning disability is and how it presents before providing a brief historical background on UK government policies aimed at protecting and promoting the rights of people with LDs. It then discusses some of the major challenges involved in providing care and support for people with LDs, focusing on issues relating to health inequalities, employment, mental health, improving decision-making by people with LDs, housing, and financial constraint. The chapter concludes with an assessment of future prospects for services for people with LDs.

Decision Making in Learning Disability Nursing

2013 ◽  
Author(s):  
Sue Hart ◽  
Eva Scarlett
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Learning Disabilities ◽  
Nursing Education ◽  
Learning Disability ◽  
Standard Of Care ◽  
Mental Health Nursing ◽  
Clear Cut ◽  
Mental Health Settings ◽  
Health Nursing

This chapter focuses on exploring decision making in the learning disability nursing field of practice. Previous chapters have covered the background about decision making, the principles, tools, and the use of evidence, as well as the way in which decision making fits in with the Nursing and Midwifery Council (NMC) Standards for Pre-Registration Nursing Education (NMC 2010) and competencies. The content of these early chapters and learning will help you to build your understanding of the issues when applied particularly to learning disability nursing skills in practice. This chapter also follows those addressing decision making in mental health nursing, children and young people’s nursing, and adult nursing. This ‘separating out’ of the fields of practice is helpful to give particular clarity and focus to issues relevant within them. It is, however, equally important to remind you that these apparently clear-cut distinctions between the disciplines are not necessarily reflected in practice, and that clients and patients do not always fit neatly into these artificial ‘boxes’. People with a learning disability have a right to equal treatment from registered nurses in adult and mental health settings, and children and young people with learning disabilities should expect the same standard of care as their typically developing peers. The NMC’s The Code: Standards of Conduct, Performance and Ethics for Nurses and Midwives (NMC 2008: 3) reminds us that ‘You must not discriminate in any way against those in your care’ and that ‘You must treat people as individuals and respect their dignity’. So, whatever your chosen future field of practice, please read on, because when people with learning disabilities require nursing, they are—and always will be—your responsibility too. Case study 12.1 has been chosen intentionally to highlight the partnership working and decision making that can go on between adult nurse specialists and learning disability nurses. The underpinning value base of decision making in learning disability nursing today is best understood with brief reference to the past. It is in recent memory for many service users that ‘home’ was a long-stay hospital ward or villa, which, despite the best efforts of nursing staff, would invariably be managed along quite regimented lines.

Learning disability and the Scottish Mental Health Act

2017 ◽  
Vol 11 (2) ◽  
pp. 74-82
Author(s):  
Heather Welsh ◽  
Gary Morrison
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Learning Disabilities ◽  
Mental Disorder ◽  
Learning Disability ◽  
Psychotic Disorders ◽  
Content Type ◽  
Mental Health Legislation ◽  
Scottish Government ◽  
Health Legislation

Purpose The purpose of this paper is to investigate the use of the Mental Health (Care and Treatment) (Scotland) Act 2003 for people with learning disabilities in Scotland, in the context of the recent commitment by the Scottish Government to review the place of learning disability (LD) within the Act. Design/methodology/approach All current compulsory treatment orders (CTO) including LD as a type of mental disorder were identified and reviewed. Data was collected on duration and type of detention (hospital or community based) for all orders. For those with additional mental illness and/or personality disorder, diagnoses were recorded. For those with LD only, symptoms, severity of LD and treatment were recorded. Findings In total, 11 per cent of CTOs included LD as a type of mental disorder. The majority of these also included mental illness. The duration of detention for people with LD only was almost double that for those without LD. A variety of mental illness diagnoses were represented, psychotic disorders being the most common (54 per cent). Treatment was broad and multidisciplinary. In all, 87 per cent of people with LD only were prescribed psychotropic medication authorised by CTO. Originality/value There has been limited research on the use of mental health legislation for people with learning disabilities. This project aids understanding of current practice and will be of interest to readers both in Scotland and further afield. It will inform the review of LD as a type of mental disorder under Scottish mental health law, including consideration of the need for specific legislation.

Palliative and end-of-life care for people with learning disabilities

2019 ◽  
pp. 777-784
Keyword(s):  
Learning Disabilities ◽  
Intellectual Disability ◽  
Learning Disability ◽  
End Of Life ◽  
Early Onset ◽  
End Of Life Care ◽  
Life Care ◽  
The World ◽  
The Uk

This chapter highlights some of the issues and challenges which exist in the provision of palliative and end-of-life care for people with learning disabilities and how some of these can be addressed. The challenges fall into four key areas: assessment, communication, consent, and bereavement. The reader is also signposted to websites and resources which are helpful in caring for people with learning disability at the end of their life. Concerns exist around choice and the quality of end-of-life care that people with learning disabilities may be offered. A number of different terms have evolved over the years for ‘learning disability’. Currently this term is used in the UK, but in Europe and in other parts of the world, the term ‘intellectual disability’ is used. Internationally there is a consensus that a learning disability can be identified when the following criteria are present: intellectual impairment (known as reduced IQ), social or adaptive dysfunction combined with reduced IQ, and early onset. It is thought that around 2.5% of the population in the UK has a learning disability, but it has also been predicted that this may increase by 1% per year over the next number of years.

scholarly journals Mental health services for adults with learning disabilities

2004 ◽  
Vol 184 (4) ◽  
pp. 291-292 ◽  
Author(s):  
Nick Bouras ◽  
Geraldine Holt
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Human Rights ◽  
Learning Disabilities ◽  
Mental Retardation ◽  
Personality Disorders ◽  
Community Care ◽  
Mental Handicap ◽  
Adults With Learning Disabilities ◽  
The Uk

Services for people with learning disabilities have been transformed since the late 1960s by the move from institutional to community care. (Learning disabilities is the term currently used in the UK in preference to mental retardation, developmental disabilities and mental handicap.) Important changes include the progress towards integration, participation, inclusion and choice for people with learning disabilities, which have occurred in the context of the broader civil and human rights movements. It is time to examine the services delivered to people with learning disabilities and comorbid psychiatric disorders (mental illness, personality disorders, behavioural problems with aggression) and the evidence for their effectiveness.

scholarly journals Feeling down and understanding depression

2017 ◽  
Vol 11 (1) ◽  
pp. 2-7
Author(s):  
Peter Cronin ◽  
Liam Peyton ◽  
Eddie Chaplin
Keyword(s):  
Mental Health ◽  
Learning Disabilities ◽  
Learning Disability ◽  
Lived Experience ◽  
Design Methodology ◽  
Positive Mental Health ◽  
Mental Wellbeing ◽  
Content Type ◽  
Self Help ◽  
Insight Into

Purpose The purpose of this paper is to offer a perspective on depression and self-help from two experts with lived experience of learning disabilites. Design/methodology/approach This paper outlines the authors’ presentation and experiences at the recent Learning Disability Today conference. Findings The paper shares some things we can do to help our mental wellbeing. Originality/value This paper offers the view of two people with learning disabilities lived experience of depression. The paper also offers and insight into some of the strategies they use to manage and encourage positive mental health.

The mental health needs of older people with learning disability

2005 ◽  
Vol 15 (3-4) ◽  
pp. 245-253 ◽  
Author(s):  
Patrick SG Chance
Keyword(s):  
Mental Health ◽  
Learning Disabilities ◽  
Older People ◽  
Learning Disability ◽  
Learning Disabled ◽  
Health Needs ◽  
Differential Mortality ◽  
Functional Impairments ◽  
Mental Health Needs ◽  
Care Needs

The term ‘older people with learning disability’ refers to a highly heterogeneous group of people. By definition, they all have delayed or abnormal early development, together with significant intellectual and functional impairments, but they differ considerably in terms of cause, developmental profile, nature and degree of impairments and their social and personal backgrounds. Overall, people with learning disabilities make up only a small minority of the population, however it is well recognized that they have increased overall health care needs, including mental health needs. It has been estimated there are 210 000 people living in England and Wales who have a severe or profound learning disability: only 25 000 (12%) of these are older people aged over 60 years. Of the 1.2 million people with mild or moderate learning disability, 265 000 (21%) of these are older people over the age of 60. Life expectancy seems to be influenced by severity of learning disability, the age profile of the mild to moderate learning-disabled population being much more closely matched to that of the general population. As a result of this differential mortality, across the spectrum of disability there is a reduced level of learning disability with advancing age, and older people with learning disabilities, when considered as a group, have higher levels of functional ability (and reduced levels of challenging behaviour) than the younger group.

scholarly journals Evaluating specialist autism teams’ provision of care and support for autistic adults without learning disabilities: the SHAPE mixed-methods study

2020 ◽  
Vol 8 (48) ◽  
pp. 1-200
Author(s):  
Bryony Beresford ◽  
Suzanne Mukherjee ◽  
Emese Mayhew ◽  
Emily Heavey ◽  
A-La Park ◽  
...  
Keyword(s):  
Mental Health ◽  
Learning Disabilities ◽  
Cost Effectiveness ◽  
Qualitative Study ◽  
Health Services ◽  
Support Group ◽  
Cost Effective ◽  
Service Characteristics ◽  
Low Intensity ◽  
Care And Support

Background The National Institute for Health and Care Excellence recommends that every locality has a ‘Specialist Autism Team’: an specialist autism, community-based, multidisciplinary service that is responsible for developing, co-ordinating and delivering care and support. The National Institute for Health and Care Excellence recommended that this novel delivery model was evaluated. Objectives The objectives were to identify services fulfilling the National Institute for Health and Care Excellence’s description of a Specialist Autism Team; to describe practitioner and user experiences; to investigate outcomes; to identify factors associated with these outcomes; and to estimate costs and investigate cost-effectiveness of these services. Design During stage 1, desk-based research and a survey to identify Specialist Autism Teams were carried out. Stage 2 comprised a mixed-methods observational study of a cohort of Specialist Autism Team users, which was followed for up to 2 years from the assessment appointment. The cohort comprised users of a Specialist Autism Team not previously diagnosed with autism (the ‘Diagnosis and Support’ group) and those already diagnosed (the ‘Support-Only’ group). Stage 2 also involved a nested qualitative study of senior practitioners and an exploratory comparison of the Diagnosis and Support group with a cohort who accessed a service which only provided autism diagnostic assessments (‘Diagnosis-Only’ cohort). Setting The setting in stage 2 was nine Specialist Autism Teams; three also provided a regional diagnostic assessment service (used to recruit the Diagnosis-Only cohort). Participants There were 252 participants in the Specialist Autism Team cohort (Diagnosis and Support, n = 164; Support Only, n = 88) and 56 participants in the Diagnosis-Only cohort. Thirty-eight participants (across both cohorts) were recruited to the qualitative evaluation and 11 practitioners to the nested qualitative study. Main outcome measures The World Health Organization Quality of Life assessment, abbreviated version (psychological domain) and the General Health Questionnaire (12-item version). Data sources Self-reported outcomes, qualitative interviews with users and focus groups with practitioners. Results A total of 18 Specialist Autism Teams were identified, all for autistic adults without learning disabilities. Services varied in their characteristics. The resources available, commissioner specifications and clinical opinion determined service design. Practitioners working in Specialist Autism Teams recruited to stage 2 reported year-on-year increases in referral rates without commensurate increases in funding. They called for an expansion of Specialist Autism Teams’ consultation/supervision function and resources for low-intensity, ongoing support. For the Specialist Autism Team cohort, there was evidence of prevention of deterioration in outcomes and positive benefit for the Diagnosis and Support group at the 1-year follow-up (T3). Users of services with more professions involved were likely to experience better outcomes; however, such services may not be considered cost-effective. Some service characteristics were not associated with outcomes, suggesting that different structural/organisational models are acceptable. Findings suggest that one-to-one work for mental health problems was cost-effective and an episodic approach to delivering care plans was more cost-effective than managed care. Qualitative findings generally align with quantitative findings; however, users consistently connected a managed-care approach to supporting improvement in outcomes. Among the Diagnosis-Only cohort, no changes in mental health outcomes at T3 were observed. Findings from the interviews with individuals in the Diagnosis and Support group and Diagnosis-Only cohort suggest that extended psychoeducation post diagnosis has an impact on immediate and longer-term adjustment. Limitations Sample size prohibited an investigation of the associations between some service characteristics and outcomes. Comparison of the Diagnosis-Only cohort and the Diagnosis and Support group was underpowered. The economic evaluation was limited by incomplete costs data. Conclusions The study provides first evidence on the implementation of Specialist Autism Teams. There is some evidence of benefit for this model of care. Service characteristics that may affect outcomes, costs and cost-effectiveness were identified. Finding suggest that extended psychoeducation post diagnosis is a critical element of Specialist Autism Team provision. Future work We recommend a comparative evaluation of Specialist Autism Teams with diagnosis-only provision, and an evaluation of models of providing consultation/supervision and low-intensity support. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 48. See the NIHR Journals Library website for further project information.

scholarly journals Mental health of children with learning disabilities†

2006 ◽  
Vol 12 (2) ◽  
pp. 130-138 ◽  
Author(s):  
Pru Allington-Smith
Keyword(s):  
Mental Health ◽  
Learning Disabilities ◽  
Social Services ◽  
Mental Health Problems ◽  
Psychiatric Service ◽  
Financial Cost ◽  
Hyperactivity Disorder ◽  
Team Working ◽  
Behavioural Difficulties ◽  
The Uk

Children and adolescents with learning disabilities have high rates of mental health problems and behavioural difficulties. Comorbid disorders such as epilepsy, autism and attention-deficit hyperactivity disorder are common. Despite this, many areas in the UK are failing to provide a psychiatric service for these young people and their families. The children suffer as a result and may have to move away from home unnecessarily, at enormous emotional and financial cost. Each area should have a specialised multidisciplinary health team working closely with colleagues from education and social services to assist these complex children and give them the best chance to fulfil their potential.

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