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Journal

Mental Health and Learning Disabilities Research and Practice

Publisher:
South West Yorkshire Mental Health NHS Trust and University of Huddersfield

Mental Health and Learning Disabilities Research and Practice aims to disseminate South West Yorkshire Mental Health NHS Trust and the University of Huddersfield research findings that are related to mental health and learning disabilities; disseminate findings from mental health research programmes or projects that South West Yorkshire Mental Health NHS Trust and the University of Huddersfield, and their partners, are involved in; provide an opportunity for practitioners to: share research findings, service developments, and educational developments. The title aims to appeal to a wide range of mental health practitioners, social care practitioners, researchers, educators, users of mental health services, carers, and voluntary sector workers. This title ceased with 8(1) Autumn 2011.

Journal article

Variation in rates of inpatient admissions and lengths of stay experienced by adults with learning disabilities in England

Authors:
JAMES Elaine, HATTON Chris, BROWN Mark
Journal article citation:
Tizard Learning Disability Review, 22(4), 2017, pp.211-217.
Publisher:
Emerald

Purpose: The purpose of this paper is to analyse rates of inpatient admissions for people with learning disabilities in England and to identify factors associated with higher rates of inpatient admission. Design/methodology/approach: Secondary analysis of data submitted as part of the Transforming Care programme in England. Findings: 2,510 people with learning disabilities in England were inpatients on 31st March 2016. Findings indicate that people with learning disabilities are at risk of higher rate of inpatient admission than can be explained by prevalence within the general population; this risk may be associated with areas where there are higher numbers of inpatient settings which provide assessment and treatment for people with learning disabilities. Research limitations/implications: Variability in the quality of the data submitted by commissioners across the 48 Transforming Care Plan areas mean that greater attention needs to be paid to determining the validity of the common reporting method. This would improve the quality of data and insight from any future analysis. Practical implications: The study’s findings are consistent with the hypothesis that geographical variations in the risk of people with learning disabilities being admitted to inpatient services are not consistent with variations in prevalence rates for learning disability. The findings support the hypothesis that building alternatives to inpatient units should impact positively on the numbers of learning disabled people who are able to live independent lives. Originality/value: This is the first study which examines the data which commissioners in England have reported to NHS England on the experience of people with learning disabilities who are admitted as inpatients and to report on the possible factors which result in higher rates of inpatient admission. (Publisher abstract)

Journal article

What is normal behaviour in persons with developmental disabilities?

Authors:
DOSEN Anton, De GROEF Johan
Journal article citation:
Advances in Mental Health and Intellectual Disabilities, 9(5), 2015, pp.284-294.
Publisher:
Emerald

Purpose: Annoying and bothersome behaviours among persons with developmental disabilities (DD) is a relatively frequent phenomenon. However, not all behaviour that is difficult to accept in its surroundings should be seen as abnormal or problem behaviour (PB). Some of these behaviours may be an expression of a person’s psychosocial needs and may be considered as adaptive and normal. The paper aims to discuss these issues. Design/methodology/approach: Authors attempt to discuss relevant issues in persons with DD which have an impact on their behaviour, intending in this way to define criteria for a reliable differentiation between normal and abnormal behaviour and psychiatric disorders. Findings: Differentiating between normal and abnormal may be a difficult task for a professional treating persons with DD because of the lack of adequate criteria for such differentiation. The problem becomes even more complex when one attempts to differentiate between PB and psychiatric disorder. By approaching the subject from a developmental perspective and by determining the level of the person’s emotional development, insight in subjective person’s experiences was achieved. On the ground of a “good practice” the authors made schemata outlining criteria for differentiation between these constructs. Originality/value: The application of these schemata in the practice made it easier to establish appropriate diagnoses and was favourable for the planning of adequate treatment and support of persons with DD and mental health problems. (Publisher abstract)

Journal article

Application of community treatment orders (CTOs) in adults with intellectual disability and mental disorders

Authors:
GUPTA Jaya, et al
Journal article citation:
Advances in Mental Health and Intellectual Disabilities, 9(4), 2015, pp.196-205.
Publisher:
Emerald

Purpose: The purpose of this paper is to explore use of community treatment orders (CTOs) in adults with intellectual disability (ID) and mental health problems across England and Wales. Design/methodology/approach: A web-based exploratory survey was sent to 359 consultants on the database of the Faculty of the Psychiatry of ID, Royal College of Psychiatrists who had declared ID as their main speciality. Socio-demographic details of responding consultants, clinical characteristics of adults with ID on CTO, subjective views of consultants on using CTOs in people with ID were collected and analysed. Findings: In total, 94 consultant questionnaires were returned providing information on 115 patients detained under CTO. More than 75 per cent of the respondents had used CTO in their clinical practice. Patients subject to CTO were generally young, white males with mild ID and living in supported accommodation. CTOs were primarily used in situations of non-engagement (52.2 per cent), non-compliance with medication (47 per cent) or non-compliance with social care supports (49.6 per cent). Practical implications: Responding consultants expressed concerns about encroachment of civil liberties and ethics of using CTOs in people with ID who may lack capacity and stressed that decision to use CTOs needs to be therefore done on individual basis. Originality/value: This is the first national study to examine the practice of applying CTOs in adults with ID and mental disorders. Current practice is based on evidence from research done in adults with normal intelligence. Further research is needed to investigate the utility of CTOs in routine clinical practice in adults with ID and mental disorders. (Publisher abstract)

Journal article

It's good to talk

Author:
McMILLAN Ian
Journal article citation:
Learning Disability Today, 15(2), March/April 2015, pp.12-13.
Publisher:
Pavilion
Place of publication:
Hove

To help to make talking therapies more accessible to people with learning disabilities and mental health issues Oxleas NHS Foundation Trust launched the TLC service, a therapeutic service for Greenwich residents with learning disabilities in July 2013. From launch to the end of 2014 the service received over 50 referrals. This article explains how the service helped one 21-year-old who was unemployed and was also experiencing severe anxiety. (Edited publisher abstract)

Journal article

Thematic analysis of the effectiveness of an inpatient mindfulness group for adults with intellectual disabilities

Authors:
YILDIRAN Hatice, HOLT Rachel R.
Journal article citation:
British Journal of Learning Disabilities, 43(1), 2015, pp.49-54.
Publisher:
Wiley-Blackwell

The study focused on the effectiveness of group mindfulness for people with intellectual disabilities in an assessment and treatment unit. Six participants with mild or moderate intellectual disabilities were interviewed using semi-structured interviews. The interviews focused on identifying the benefits and difficulties of using mindfulness. The interviews were analysed using thematic analysis. Five themes were identified which were categorised into interpersonal ('helping people') and intrapersonal ('focusing on one particular thing'; 'improving skills'; 'get rid of all nasty bad stuff you want to get rid of') benefits. The theme 'bit too late to teach old dog new tricks' captured the difficulties encountered. The themes highlighted that people with intellectual disabilities were able to form an understanding of mindfulness and were able to benefit from the intervention. (Publisher abstract)

Journal article

Expert opinions on community services for people with intellectual disabilities and mental health problems

Authors:
HEMMINGS Colin, AL-SHEIKH Alaa
Journal article citation:
Advances in Mental Health and Intellectual Disabilities, 7(3), 2013, pp.169-174.
Publisher:
Emerald

A total of 14 multidisciplinary professionals from specialist intellectual disabilities services in the UK were interviewed about their opinions on four key areas of community service provision. These included the review and monitoring of service users, their access to social, leisure and occupational activities, the support, advice and training around mental health for a person's family or carers and “out of hours” and crisis responses. The interview data was used for coding using the NVivo 7 software package and then analyzed using thematic analysis. Analysis of participants' views on these key essential service components produced wider themes of importance. The ten major emergent themes for services were: their configuration/structure, their clarity of purpose/care pathways, their joint working, their training, their flexibility, their resources, their evidence-base, being holistic/multidisciplinary, being needs-led/personalised and providing accessible information. Selective quotations are included in the article to illustrate the main themes. These views of experts can help inform further research for the development and the evaluation of services. (Edited publisher abstract)

Journal article

Attachment, intellectual disabilities and mental health: research, assessment and intervention

Authors:
SCHUENGEL Carlo, et al
Journal article citation:
Journal of Applied Research in Intellectual Disabilities, 26(1), 2013, pp.34-46.
Publisher:
Wiley-Blackwell

Research and practice have recently started to explore the value of attachment theory for understanding and alleviating the challenges that persons with intellectual disabilities face in mental health and social participation. The purpose of this paper is to review the current state of the art on attachment and intellectual disabilities, looking at possible clinical implications for assessment, prevention, intervention and education. The findings are discussed under the following concepts: attachment behaviours; attachment relationships; attachment bonds; attachment representations; attachment styles; and attachment disorders. Of these various attachment-related concepts, insights into attachment behaviours and relationships show the most promise for practical applications in the field of intellectual disabilities. Findings on representations, styles and disorders are inconclusive or preliminary. The paper concludes that attachment-informed research and practice can be part of emerging developmental understanding of functioning with intellectual disabilities.

Journal article

Strategic thinking

Authors:
DAVIES Jill, BURKE Christine
Journal article citation:
Mental Health Today, September 2012, pp.12-14.
Publisher:
Pavilion
Place of publication:
Hove

People with learning disabilities are more likely to develop mental health problems compared to the general population. The Government’s mental health strategy, ‘No health without mental health’ (DH, 2011), makes several references to people with learning disabilities. In particular, it highlights the importance of mental health services for people with learning disabilities and autism, the need to ensure that mainstream services are inclusive to this group, including that staff have appropriate skills and can provide reasonable adjustments to meet individual needs. The strategy also mentions the need for early intervention to prevent later problems for children with special educational needs and disabilities, including those who have underlying or associated mental health problems. In 2012, the Government issued an accompanying implementation framework that aims to translate the ideals of the strategy into concrete actions on a local level. This article discusses what the implementation framework means for people with learning disabilities. It shows that, despite the strategy highlighting the needs of people with learning disabilities, the framework offers little specifically for this group. This raises concern that this group will remain off the radar for those in mainstream services and organisations that could support them to maintain their mental health and wellbeing.

Journal article

Strategic thinking

Authors:
DAVIES Jill, BURKE Christine
Journal article citation:
Learning Disability Today, October 2012, pp.16-17.
Publisher:
Pavilion
Place of publication:
Hove

People with learning disabilities are more likely to develop mental health problems compared to the general population. The Government’s mental health strategy, ‘No health without mental health’ (DH, 2011), makes several references to people with learning disabilities. In particular, it highlights the importance of mental health services for people with learning disabilities and autism, the need to ensure that mainstream services are inclusive to this group, including that staff have appropriate skills and can provide reasonable adjustments to meet individual needs. The strategy also mentions the need for early intervention to prevent later problems for children with special educational needs and disabilities, including those who have underlying or associated mental health problems. In 2012, the Government issued an accompanying implementation framework that aims to translate the ideals of the strategy into concrete actions on a local level. This article discusses what the implementation framework means for people with learning disabilities. It shows that, despite the strategy highlighting the needs of people with learning disabilities, the framework offers little specifically for this group. This raises concern that this group will remain off the radar for those in mainstream services and organisations that could support them to maintain their mental health and wellbeing.

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