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Geographical barriers to mental health service care among individuals with an intellectual disability in the Republic of Ireland
- Authors:
- RAMSAY Hugh, et al
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 13(4), 2016, pp.261-268.
- Publisher:
- Wiley
People with an intellectual disability (ID) are more likely to experience mental health difficulties than others. The United Nations (UN) Convention on the Rights of Persons with Disabilities (CRPD) states that health services should be provided close to people's own communities. This article examines differences in access to psychiatry services for those with an ID according to geography, in the context of a small European country (Republic of Ireland). The sample consisted of 753 individuals aged 40 and over with ID in the Republic of Ireland, with data collected from the Intellectual Disability Supplement of the Irish Longitudinal Study on Aging (IDS-TILDA). The primary outcome of interest was attendance with any psychiatrist and the primary independent variables were area of residence (health service region and degree of county urbanicity). Logistic regression was used to analyse associations, unadjusted and then controlling for age group, gender and level of ID. Secondary analysis examined factors associated with anti-psychotic prescription without psychiatrist supervision. Treatment by a psychiatrist was associated with both health region (p = 0.029) and degree of urbanicity (p = 0.015) before controlling for group differences but only the health region was significantly associated after controlling for age, gender and level of ID. Antipsychotic use without a psychiatrist was associated with degree of urbanicity (p = 0.036) but not with health service region (p = 0.989). Geographic factors are associated with access to mental health services among those with ID in the Republic of Ireland. This may be partly due to movement of people with ID away from their area of origin, highlighting the need for locally tailored specialist ID mental health teams and for further research into barriers to treatment. Additional work in other countries will further understanding of similar roles of geographic factors in mediating mental health services access. (Edited publisher abstract)
Quality of life: a survey of parents of children/adults with an intellectual disability who are availing of respite care
- Authors:
- CAPLES Maria, SWEENEY John
- Journal article citation:
- British Journal of Learning Disabilities, 39(1), March 2011, pp.64-72.
- Publisher:
- Wiley
Some two-thirds of the people registered on the Irish National Intellectual Disability Database live at home, with family members providing support. Use of respite care services by parents with a child/adult with an intellectual disability (ID) is growing in the context of social policy initiatives for greater social inclusion of people with disabilities. Parents often require assistance in this caring role, needing to be supported with reliable, flexible and responsive services. Parents often have to negotiate complex barriers to access support services such as respite, health or social care. This article draws on a recent Irish study that investigated the quality of life of 49 parents of people with an intellectual disability and who are using respite care. In general, results indicated that parents were experiencing good to excellent quality of life. However, demand exceeded supply, with many parents facing a lengthy wait gaining access to respite care. However, more research needs to be undertaken out to establish what services are deemed most valuable to parents.
Inequalities in respite service provision: insights from a national, longitudinal study of people with intellectual disabilities
- Authors:
- McCONKEY Roy, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 23(1), January 2010, pp.85-94.
- Publisher:
- Wiley
Using data from a national database in Ireland of around 16,000 people with learning disabilities living with family carers, the availability of overnight respite provision was monitored over an 8-year period along with the recorded needs for such services. Despite marked rises in the number of people receiving respite breaks resulting from increased government funding, there were marked inequalities in the availability of provision across the country. In recent years the inequalities decreased but still remained. The proportion of families requiring breaks also rose and a similar pattern of inequalities were found here too. This study highlighted some of the complexities in reducing inequalities in the provision of respite services and in identifying the need for them. It would be advantageous to develop more explicit criteria regarding the need for respite provision and to record the family's preferences for the form this provision might take. These adjustments would add to the value of any national database as a service planning tool.
Patterns of leisure participation among adolescents with a mild intellectual disability
- Authors:
- BUTTIMER John, TIERNEY Edel
- Journal article citation:
- Journal of Intellectual Disabilities, 9(1), March 2005, pp.25-42.
- Publisher:
- Sage
- Place of publication:
- London
The aim of this study was to investigate the leisure and recreational activities of a cohort of 34 students attending a full-time special school as reported by the students and their parents. Leisure activities which were mostly solitary and passive in nature were identified as those being most commonly engaged in. Barriers to leisure were also identified, with ‘access to’ and ‘location of’ the leisure facilities being barriers perceived by both students and parents. Data on aspects of leisure use, e.g. enjoyment, participation, assistance required, socialisation and choice, were also collected.
'It's the system working for the system': carers' experiences of learning disability services in Ireland
- Author:
- POWER Andrew
- Journal article citation:
- Health and Social Care in the Community, 17(1), February 2009, pp.92-98.
- Publisher:
- Wiley
The aim of this article is to examine the experiences of families with young adults with learning disabilities trying to access services. The landscape of disability services for this group is made up of day care, special vocational training and respite places. It aims to identify the extent of an implementation gap between government rhetoric and the degree to which services are characterised as being non-supportive interactions on the ground. Using Ireland as a case study, during a time when the economy is booming and government rhetoric claims unparalleled developments in allocating resources and extra respite 'places', this article identifies the main challenges faced by family carers associated with accessing appropriate services for their disabled adult child, in their attempt to achieve greater independence. This article reports the findings of a qualitative study in which individual semi structured interviews were held with family carers (n = 25) and representatives from national carer organisations (n = 6) in Ireland. These were people caring for an adult (18–30 years) with a learning disability and their experiences were also useful in cross-checking the carer organisation interviews. The findings show that there is limited flexibility, choice and availability in meeting the preferences of the service-users, and throughout the study, services were characterised as being non-supportive interactions. This is not simply symptomatic of a lack of resources. Despite improved funding, supportive attitudes and flexibility are still crucial in meeting user requirements at the level of delivery; thus highlighting that often the system works for the system, not for the user.
Family carers of adult persons with intellectual disabilities on the island of Ireland
- Authors:
- BARRON Steve, McCONKEY Roy, MULVANY Fiona
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 3(2), June 2006, pp.87-94.
- Publisher:
- Wiley
Many families provide lifelong support to their relative with an intellectual disability. However, relatively little information is available for national populations on the characteristics of the people for whom these families care and the supports they receive or need. A database of all persons in receipt of intellectual disability services has been operating in the Republic of Ireland since 1995 and records details of those living with family carers. In Northern Ireland, regional databases provide similar information. Using both sources, data were obtained on over 12,500 people living with family carers; half of whom lived with two parents, around 30% with a lone parent, and just under 20% with another relative. More people in Northern Ireland were identified as living with family carers, which was attributed mainly to less available residential alternatives. Only a minority of carers received respite breaks and domiciliary supports although higher proportions required them. The authors conclude that family care arrangements have received relatively little attention within government policy making, and hence service provision has been largely reactive. Future research should focus on the changing needs of carers over time and how they can be better supported in their role.
Our homes: an inclusive study about what moving house is like for people with intellectual disabilities in Ireland
- Authors:
- SALMON Nancy, et al
- Journal article citation:
- British Journal of Learning Disabilities, 47(1), 2019, pp.19-28.
- Publisher:
- Wiley
Background: Supporting people with intellectual disabilities to live well in communities they choose is deinstitutionalisation's central aim and endorsed by the United Nations Convention on the Rights of Persons with Disabilities (CRPD) (UN, 2006). This study focused on the experiences of people with intellectual disabilities in Ireland when moving home using an inclusive research approach. Method: This inclusive research project employed a qualitative approach. Participants included 19 men and 16 women (total n = 35) with ages ranging from 22 to 77 years. Structured interviews attended to the experience of moving home and the supports accessed during and after the transition to community living. Results: Thematic analysis yielded four themes: “expressing choice” in the moving process; “feeling connected or isolated when moving”; “accessing supports during and after the move”; and finally, participants' reflections on “experiencing vulnerability and feeling safe” while resettling. Conclusions: This is the first study about people with intellectual disabilities moving home to be collaboratively designed and completed by an inclusive research team. Although much is understood about the long‐term benefits of engaging in meaningful choices about housing and supports, concerns remain about the extent to which the will and preferences of people with intellectual disabilities in Ireland are respected when moving home. (Edited publisher abstract)