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Service provision for people with learning disabilities and psychiatric disorders in Northern Ireland
- Author:
- TAGGART Laurence
- Journal article citation:
- Advances in Mental Health and Learning Disabilities, 1(1), March 2007, pp.18-21.
- Publisher:
- Emerald
This article provides an overview of service provision for people with learning disabilities and psychiatric disorders in Northern Ireland. The first part of the article briefly describes how learning disability services are structured, and highlights how service provision across Northern Ireland is set to dramatically change as a result of Equal Lives (Department of Health, Social Services and Public Safety, 2005) and overall healthcare modernisation. Secondly, the article explores the prevalence rates of psychiatric disorders in people with learning disabilities in light of recent Northern Irish studies. Third, a review of current psychiatric service provision is provided, this is followed by an examination of recent hospital and community developments. Finally, the article describes some educational and research developments that have focused on the mental health of people with learning disabilities.
An exploration of lifestyle/obesity programmes for adults with intellectual disabilities through a realist lens: impact of a ‘context, mechanism and outcome’ evaluation
- Authors:
- TAGGART Laurence, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 34(2), 2021, pp.578-593.
- Publisher:
- Wiley
Background: Obesity is higher in people with intellectual disabilities. Aims: There are two aims of this explorative paper. Firstly, using a realist lens, to go beyond ‘what works’ and examine the ‘context, mechanisms and outcomes’ (CMO) of lifestyle/obesity programmes for this population. Second, using a logic model framework to inform how these programmes could be implemented within practice. Method: We explored six‐review papers and the individual lifestyle/obesity programmes that these papers reviewed using the CMO framework. Results: There were few theoretically underpinned, multi‐component programmes that were effective in the short to long‐term and many failed to explore the ‘context and mechanisms’. We developed a logic model and engaged in two co‐production workshops to refine this model. Discussion: Using a realist approach, programmes need to be underpinned by both individual and systems change theories, be multi‐component, have a closer understanding of the interplay of the ‘context and mechanisms’, and co‐designed using a logic model framework. (Edited publisher abstract)
Examining the support needs of ageing family carers in developing future plans for a relative with an intellectual disability
- Authors:
- TAGGART Laurence, et al
- Journal article citation:
- Journal of Intellectual Disabilities, 16(3), September 2012, pp.217-234.
- Publisher:
- Sage
- Place of publication:
- London
Due to the increased life expectancy of people with intellectual disability, they are now more likely to be living with an ageing family carer. The aim of this study was to examine the support needs of ageing family carers in developing future plans for a relative with an intellectual disability. A mixed methods design was employed. In stage 1, a structured questionnaire was used to collate information on the health, caregiving demands and future planning preferences of 112 parent and sibling carers aged 60–94 years. In stage 2, 19 in-depth semi-structured interviews were undertaken with a sample of carers to explore a range of issues around future planning. Over half of the carers were lone carers, mainly female, with many reporting a wide range of health problems. The main preference was for the person to remain in the family home, with either the family or paid staff to support them. A minority of parent carers preferred the person to move into the home of a sibling, although some favoured the person moving to a residential facility with other people with intellectual disabilities. Four main themes were identified around future planning: unremitting apprehension; the extent of planning; obstacles encountered; and solutions for future planning. Avoidance, lack of guidance and a lack of appropriate residential provision were cited as obstacles to making future plans compounded by the emotional upset experienced by carers in thinking about the future.
England and Northern Ireland policy and law update relating to mental health and intellectual disability
- Authors:
- CHAPLIN Eddie, TAGGART Laurence
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 6(3), 2012, pp.144-150.
- Publisher:
- Emerald
Two years ago this journal presented overviews and perspectives from across the UK relating to mental health and intellectual disability. This article aims to bring readers up to date with policy developments and current issues in England and Northern Ireland. As well as looking at changes to policy and legislation, the paper highlights the differences and shared concerns for people with intellectual disability living in the two countries, for example access to equitable health care. The review found that, in spite of shared visions of inclusion and equality in mental health care, there are major differences in how the countries approach these issues. This has been emphasised by recent shifts in policy. In Northern Ireland strategies are being designed to inform the delivery of evidence based services for the future while in England there has also been a move towards public protection within mental health legislation and the reaffirmation of the need to for more individualised services. It is concluded that although there is a desire for change, the reality is that the policies and legislation introduced to address issues such as accessing mental health care and service standards have still to make a significant impact to people's daily lives.
Listening to people with intellectual disabilities who misuse alcohol and drugs
- Authors:
- TAGGART Laurence, et al
- Journal article citation:
- Health and Social Care in the Community, 15(4), July 2007, pp.360-368.
- Publisher:
- Wiley
There is a dearth of research that has explored alcohol/drug use and misuse by people with intellectual disabilities. The aims of the present study were twofold: (1) to examine the insights of 10 people with intellectual disabilities into the reasons why they may misuse alcohol or drugs, and what impact this behaviour may have on them; and (2) to explore the services that they receive. Ten individuals with intellectual disabilities from the UK who were deemed to be misusing alcohol/drugs were purposively selected and interviewed. One overarching theme of the reasons for such misuse was labelled as ‘self-medicating against life's negative experiences’. This was divided into two sub-themes: ‘psychological trauma’ and ‘social distance from the community’. All the participants reported that their main source of support came from intellectual disability services, acting in both educational and liaison roles. Although seven of the individuals were referred to mainstream addiction services, they perceived this service as negative. In order to address these underlying problems, better access to a wider range of specialist services is required. Intellectual disability and mainstream addiction service providers also need to be more effective in the prevention and treatment of substance misuse by employing techniques such as motivational interviewing.
Trauma experiences of people with an intellectual disability and their implications: a scoping review
- Authors:
- McNALLY Paddy, TAGGART Laurence, SHEVLIN Mark
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 34(4), 2021, pp.927-949.
- Publisher:
- Wiley
Background: People with an intellectual disability are more vulnerable to psychological trauma compared with the general population. The aim of this scoping review was to identify the current status of the literature on trauma that is specific to the experiences of adults with an intellectual disability, living in community settings. Methods: A scoping review was conducted using the Arksey and O'Malley (International Journal of Social Research Methodology, 2005, 8, 19) framework. Forty-one international papers were reviewed spanning 2000–2020, and their quality assessed using the MMAT. Findings: (1) Aggressive behaviours can be symptoms of trauma, (2) there are appropriate assessment tools for the impact of trauma, (3) evidence-based interventions for trauma may be effective, and (4) factors associated with disability can be experienced as traumatic. Conclusion: There is a growing body of literature highlighting assessment needs and potential interventions for people with an intellectual disability who have experienced psychological trauma. Further research is needed to develop trauma-informed pathways. (Edited publisher abstract)
The lived experience of people with intellectual disabilities in post-secondary or higher education
- Authors:
- CORBY Deirdre, TAGGART Laurence, COUSINS Wendy
- Journal article citation:
- Journal of Intellectual Disabilities, 24(3), 2020, pp.339-357.
- Publisher:
- Sage
- Place of publication:
- London
The transformational role education plays in the lives of people with intellectual disabilities has not been fully examined. The purpose of this study was to explore and investigate the meanings people with intellectual disabilities construct of their experiences in post-secondary and higher education. Heideggerian hermeneutic phenomenology was the qualitative methodology adopted for the study. Individual interviews were conducted with 27 people with intellectual disabilities and analysed in stages. These stages included the creation of I-Poems offering a unique opportunity for individual participant voices to be heard. Three core themes emerged to describe living an authentic life: learning (with the emphasis on increased skills, independence and opportunities); relationships (in particular, the importance of friendships), and perceptions including the existing realities of life for those with intellectual disabilities. The findings advance previous work highlighting the link between living a more authentic life and how education transforms how people with intellectual disabilities view themselves. (Publisher abstract)
Meeting the challenge of interpretation: Hearing the voices of people with intellectual and developmental disability through I-Poems
- Authors:
- CORBY Deirdre, TAGGART Laurence, COUSINS Wendy
- Journal article citation:
- Journal of Intellectual Disabilities, 22(2), 2018, p.197–205.
- Publisher:
- Sage
- Place of publication:
- London
Including the inner perspectives of people who have intellectual disability can pose methodological challenges to qualitative researchers. This article explains how the Listening Guide was applied as an additional step in the analysis during a study which used hermeneutic interviews with people with intellectual disability as the sole method of data collection. An argument is made for the systematic application of the guide with a focus on the use of I-Poems. This article advances qualitative methodological approaches and concludes that this method of drawing attention to the participants’ own voices provides a unique basis for interpreting interviews and tasks researchers to examine the use of the Listening Guide. (Edited publisher abstract)
Healthy lifestyle behaviours for people with intellectual disabilities: an exploration of organizational barriers and enablers
- Authors:
- O'LEARY Lisa, TAGGART Laurence, COUSINS Wendy
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 31(Supplement S1), 2018, pp.122-135.
- Publisher:
- Wiley
Background: The health-related behaviours of people with intellectual disabilities may be determined by organisational influences. This innovative study aimed to explore managers’ and staffs’ perspectives on organisational influences on the promotion of healthy behaviours for this population. Method: A qualitative methodology was employed. Four focus groups with staff and eleven telephone interviews with managers were undertaken across three residential services in one region (Northern Ireland) of the UK. Transcripts were analysed thematically. Findings: The organisations involved in this study did not have the cultural ethos or capacity to sustain consistent support for staff involvement in health promotion. Organisational support and outcome-focused strategies are recommended for encouraging staff involvement in health promotion activities. Conclusion: These findings have implications for some organisations that support people with intellectual disabilities in improving the way they facilitate health promotion. They highlight the need for organisational cultures to facilitate knowledge translation and embrace evidence-based health promotion interventions. (Publisher abstract)
Optimizing the uptake of health checks for people with intellectual disabilities
- Authors:
- McCONKEY Roy, TAGGART Laurence, KANE Molly
- Journal article citation:
- Journal of Intellectual Disabilities, 19(3), 2015, pp.205-214.
- Publisher:
- Sage
- Place of publication:
- London
The provision of an annual health check for adult persons with an intellectual disability is intended to counter the health inequalities experienced by this population. This study documents the uptake of checks across general practitioner (GP) practices in Northern Ireland over a 3-year period. In all, 84% of GP practices provided health checks covering an estimated 87% of the population with intellectual (learning) disabilities. Overall 64% of people known to practices had received a health check which is significantly higher than comparable percentages of around 46% reported for England. Nevertheless the uptake by patients varied across the five trusts in Northern Ireland but less so than across the English health authorities. These variations were linked to the deployment of health facilitators. However, younger people living with families, or independently, in more socially deprived areas were less likely to have had a health check. Ongoing monitoring is needed to ensure the quality of the checks provided and that health improvement plans are implemented. (Publisher abstract)