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Mental health services for adults with learning disabilities
- Authors:
- BOURAS Nick, HOLT Geraldine
- Journal article citation:
- British Journal of Psychiatry, 184(4), April 2004, pp.291-292.
- Publisher:
- Cambridge University Press
The specialisation of mental health services for people with learning disabilities, provided by mainstream mental health services at a tertiary care level, offers a way forward. Such a solution should be instrumental in surmounting the bureaucratic barriers to care at all service levels. It would bridge the gulf between service systems and would endorse working within the National Framework for Mental Health as well as sharing resources and expertise. This service model would be compatible with other tertiary mental health services such as home treatment teams, assertive outreach services, eating disorders teams and early intervention teams for psychosis. The clinical interface between mental health and learning disability services should follow the pattern of that existing between child development teams and child and adolescent mental health teams, and old age mental health teams and geriatric services.
Mental handicap and mental health: a community service
- Authors:
- BOURAS Nick., et al
- Publisher:
- Lewisham Hospital. National Unit for Psychiatric Research and Development
- Publication year:
- 1988
- Pagination:
- 47p., tables, bibliog.
- Place of publication:
- London
Results from a survey into the extent of mental health problems in the mentally handicapped, and the provision of services to them.
Mental health in intellectual disabilities: a reader
- Authors:
- BOURAS Nick, HARDY Steve, HOLT Geraldine
- Publisher:
- Pavilion
- Publication year:
- 2012
- Pagination:
- 200p.
- Place of publication:
- Hove
The fourth edition of this reader draws together contributions from experts in the field to provide up-to-date information on mental health problems in people with intellectual disabilities. Recent changes include: The Mental Capacity Act (2005) which came into operation in 2007; the 2007 revision of The Mental Health Act (1983); and the introduction of the Deprivation of Liberty Safeguards in 2008. There is also emerging evidence of the effectiveness of psychosocial interventions for people with intellectual disabilities. The revisions encompass these changes. Two chapters are dedicated to the new legal and policy frameworks and information on the Care Programme Approach (1990) is included. There are chapters on specific mental health problems, these include: psychosis spectrum disorders; mood, anxiety and eating disorders; personality disorders and substance misuse; neuropsychiatric disorders and epilepsy; and autism. Other topics discussed include: assessment of mental health problems; biological interventions; psycho-social interventions; policy and mental health care for people with intellectual disabilities; staff support and training; consent to treatment; challenging behaviour; and working with families, children, older people and offenders. (The reader provides background knowledge for facilitators using Mental Health in Learning Disabilities: A training resource but can be used as independent resource.)
Using service user and clinical opinion to develop the SAINT: a guided self-help pack for adults with intellectual disability
- Authors:
- CHAPLIN Eddie, CRAIG Tom, BOURAS Nick
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 6(1), 2012, pp.17-25.
- Publisher:
- Emerald
Despite the greater prevalence of mental ill-health in people with intellectual disabilities compared to the general population, there has been little work specifically aimed at prevention, early detection and helping this group to cope with mental health problems. This study looked at the first stage of development of a guided self-help (GSH) pack called the Self Assessment and INTervention pack (SAINT). Delphi methods and focus groups were used to gather opinions from two groups: professionals or clinical experts (n=between 15 and 33 at different stages); and service users (n=9), to inform the contents of the SAINT. The Delphi was conducted by e-mail. Results from each round were shared between the two groups to develop a consensus. Both groups were able to reach a consensus of the items that would make up the SAINT. Delphi methods combined with focus groups were able generate the contents of the SAINT and demonstrated versatility in this dual approach. The perspectives of the groups differed. The clinical experts concentrated more on severe mental health problems whereas the service users talked more about vulnerability associated with everyday life. The next step will be to establish the reliability and validity of SAINT prior to pilot testing.
What should community services provide for adults with psychosis and learning disabilities? A comparison of the views of service users, carers and professionals
- Authors:
- HEMMINGS Colin, UNDERWOOD Lisa, BOURAS Nick
- Journal article citation:
- Advances in Mental Health and Learning Disabilities, 3(3), September 2009, pp.22-27.
- Publisher:
- Emerald
Three separate focus groups were set up to discuss community services for adults with psychosis and learning disabilities. One group comprised 6 service users, another 5 carers, and the third 5 specialist health professionals. The participants were asked which staff, treatments or interventions, and methods of working or style of service organisation make a significant contribution to helping people with psychosis and learning disabilities. Also discussed were the characteristics of service users who need more intensive services, and what form this intensive service might take. The results showed that, although there were few direct contradictions between the 3 groups, the priorities of service users, carers, and professionals often differed. The authors conclude that it is essential that service users and carers, as well as clinicians, contribute to the planning, delivery and evaluation of services in the community for adults with psychosis and learning disabilities.
The role of training in improving community care staff awareness of mental health problems in people with intellectual disabilities
- Authors:
- COSTELLO Helen, BOURAS Nick, DAVIS Hilton
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 20(3), May 2007, pp.228-235.
- Publisher:
- Wiley
Care staff play a key role in identifying individuals with intellectual disabilities and additional mental health problems. Yet, few receive training in mental health, and evidence about the effectiveness of training is scant. A pre–post study is reported, using a mental health screen and a self-report questionnaire to examine staff awareness of mental health problems and to measure whether training improved knowledge of psychopathology, attitudes towards mental health services and referral decisions. The sample was recruited from care staff from one South East London borough attending the workshop and a comparison group not in receipt of training. Prior to training, deficits in awareness were evident. The Psychiatric Assessment Schedule for Adults with a Developmental Disability (PAS-ADD) Checklist detected significant psychopathology in approximately one-third of the individuals judged to have no mental health problems according to staff. Four months after the delivery of training, significant improvements in knowledge, attitudes and referral decisions were observed. It is concluded that brief training interventions may improve awareness of mental health problems, but further research is needed to understand the referral process and to demonstrate the role of training in influencing actual staff behaviour.