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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)
A different ending: addressing inequalities in end of life care: people with a learning disability
- Author:
- CARE QUALITY COMMISSION
- Publisher:
- Care Quality Commission
- Publication year:
- 2016
- Pagination:
- 4
- Place of publication:
- Newcastle upon Tyne
This document outlines the barriers to good end of life care experienced by people with a learning disability. The report is one of a suite of documents reporting on the Care Quality Commission end of life care thematic review, and is designed to be read in conjunction with the other documents. There are challenges in delivering good end of life care in prison, and the experience of prisoners at the end of life is variable. The reviewers asked a group of people with a learning disability about what was important to them for good end of life care. They said that it was important to have family and friends nearby, to have privacy, peace and quiet, preferably not to be in hospital, to be able to go outside, and to have the support of a care coordinator when needed. They thought that services should talk more to people who have a learning disability to get their views and check that they are improving and inclusive. The document focuses on staff lack of knowledge around learning disabilities, communication and coordination of care. The Care Quality Commission encourages commissioners and providers to support early identification of people with a learning disability who may be approaching the end of life, as part of improved health care; and to make sure that health and care staff have the skills and support they need to communicate well with people with a learning disability who may be approaching the end of life. This includes access to appropriate communication aids and tools. (Edited publisher abstract)
Supporting people with learning disabilities to develop sexual and romantic relationships
- Authors:
- HARFLETT Naomi, TURNER Sue
- Publisher:
- National Development Team for Inclusion
- Publication year:
- 2016
- Pagination:
- 23
- Place of publication:
- Bath
This short literature review looks at the barriers facing people with learning disabilities wanting to develop sexual and romantic relationships and what works to support then. The review conducted searches of research evidence and of resources to support people with learning disabilities, parents/carers and staff to enable people with learning disabilities to develop relationships. This report summarises the findings of these two searches. The review highlighted that people with learning disabilities face a number of barriers to developing sexual or romantic relationships, in particular: attitudinal barriers, barriers related to support and access to information; and additional barriers for specific groups, such as LGBT people. Although a lack of information was highlighted as a barrier in the research evidence, the review of the resources found a number of resources freely available on the internet and organisations providing training around sex and relationships aimed at people with learning disabilities, staff and parents. The report includes links to resources. (Edited publisher abstract)
What influences women with intellectual disabilities to attend breast screening? Experiences of women who have and have not participated
- Author:
- WILLIS Diane S.
- Journal article citation:
- British Journal of Learning Disabilities, 44 (4), 2016, pp.269-276.
- Publisher:
- Wiley
Background: Despite breast screening in Britain being free to all women within the allotted age range, uptake of this service is often poor in women with intellectual disabilities. Reasons put forward are numerous, including poor knowledge, pain and difficulty travelling to the centre. However, what influences the decision to attend is rarely discussed. Methods: Twelve semi-structured interviews and three focused observation were undertaken with women with intellectual disabilities to explore what influenced them to participate in breast screening and their experience of having mammography. Data were analysed thematically using a blended framework. Results: Despite the experience of mammography being negative, high uptake of breast screening services was reported in this study. Pain and previous poor treatment in hospital were reasons for nonparticipation in breast screening. Although awareness about breast screening varied, those who had previous breast problems were more knowledgeable; however, there was poor awareness of the risks of hereditary breast cancer. Overall, paid-carers were found to play a key role, as means of support, information and a potential influence in determining participation in breast screening. Conclusions: There was general equality of access but an inequality in the preparation and delivery of the service which was dependent on a complex range of issues and relationships. Key to participation was preparation with the paid-carer facilitating discussions about breast screening were key to participating in mammography. This has implications on the future direction of funding and policy making. Risks associated with hereditary breast cancer and earlier presentation of breast tumours also needs highlighting. (Edited publisher abstract)
Delivering an equal right to sight
- Author:
- SeeABILITY
- Publisher:
- SeeABILITY
- Publication year:
- 2016
- Pagination:
- 68
- Place of publication:
- Epsom
This report examines evidence, good practice and the views of people with learning disabilities on what is important to them when they go for a sight test and receive eye care. It finds that people with learning disabilities experience high levels of sight problems than the general population and that they often cannot access support to enable them to access the eye care they need. Case studies highlight key issues in accessing and experiencing eye care, including lack of awareness, adjustments in practice, lack of experience and training, and systems barriers. The report also provides good practice examples of projects and initiatives which show what people with learning disabilities, their families, community opticians, and hospitals can do to improve access and experience of services. The report makes a number of recommendations, which include that working age adults with learning disabilities should be eligible for NHS funded sight tests, that eye care should be included in national learning disability policy and programmes, and available NHS funding to enable accredited community optical practices can offer longer or split appointments for people with learning disabilities. The information in the report focuses on England, but many of the findings will also be relevant to the rest of the UK. (Edited publisher abstract)
Disparities in substance abuse treatment utilization among women with intellectual disability
- Author:
- SLAYTER Elspeth
- Journal article citation:
- Journal of Social Work in Disability and Rehabilitation, 15(2), 2016, pp.96-115.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Despite concerns about health disparities among women with intellectual disabilities, little is known about substance abuse treatment access in this population. Using standardised performance measures, treatment initiation and engagement were examined retrospectively for women aged 18 to 64 (N = 3,752), men with (N = 5,732) and women without intellectual disability (N = 493,446) from 49 states in the USA. Logistic regression models of utilisation were conducted. Women in the sample were less likely than men in the sample or women without intellectual disability to utilise treatment, suggesting both gender-related and disability-related barriers. Policy and practice implications for improving the health and welfare of women with intellectual disabilities are discussed. (Edited publisher abstract)
Review of adult learning disability services phase II
- Author:
- REGULATION AND QUALITY IMPROVEMENT AUTHORITY
- Publisher:
- Regulation and Quality Improvement Authority
- Publication year:
- 2016
- Pagination:
- 66
- Place of publication:
- Belfast
Review of community services for adults with learning disability in Northern Ireland, which assesses the performance of the five health and social care trusts against the Department of Health’s Service Framework for Learning Disability. The review assessed the quality of services delivered to adults with a learning disability against 30 standards. The findings are presented in the areas of: safe care; effective care; compassionate care; and well led services. The review found staff were familiar with the content of the service framework, but that there was not a standardised approach to its implementation across the five health and social care trusts. Evidence of improvements identified since the 2013 review included: access to a wider range of day activities for adults with a learning disability; assessments by GPs of the health needs of adults with a learning disability; and the establishment of specialist teams within trusts to support carers in managing challenging behaviours. Areas requiring improvement included: the provision of family support services; an increase in the uptake of carer’s assessments and direct payments; the development of a single regional community based information system. The review makes 25 recommendations to support improvements in the provision of services for adults with a learning disability across Northern Ireland. (Edited publisher abstract)
Mental health services for children and adolescents with learning disabilities: a review of research on experiences of service users and providers
- Authors:
- JACOBS Myrthe, et al
- Journal article citation:
- British Journal of Learning Disabilities, 44(3), 2016, p.225–232.
- Publisher:
- Wiley
Background: Children and young people with learning disabilities experience high rates of mental health problems. Methods: The present study reviewed the literature on mental health services for children with learning disabilities, to identify known models of service provision and what has been experienced as effective or challenging in providing good services. Results: Children with learning disabilities and their parents experience barriers accessing mental health services that are related to a lack of information and perceptions of services as being inadequate. Service providers identified a lack of resources as a barrier to meeting needs. Although positive experiences are also observed, many parents have found services to be inappropriate or overwhelming. Conclusion: Research linking population need to available resources, and service models to services users’ outcomes would be valuable to make clear recommendations on how mental health services can address the needs of this group more effectively. (Publisher abstract)
Creative ways of talking: a narrative literature review concerning emotional support for adults with mild or moderate learning difficulties
- Author:
- MacDONALD Dee
- Journal article citation:
- British Journal of Learning Disabilities, 44(3), 2016, p.233–239.
- Publisher:
- Wiley
Background: Adults with mild or moderate learning difficulties identified a need for more opportunities to access appropriate emotional support. Materials and Methods: A narrative literature review was undertaken. Factors associated with dealing with emotional unrest, such as self-esteem/self-awareness, a person's attitude to having learning difficulties, emotional competency and friendship issues are discussed. Results: The review provides evidence that emotional unrest exists but receives little attention from supporters due to an emphasis on practical issues associated with an inclusion agenda. The review highlights a lack of research on emotional support for adults and explores reasons for this. Conclusion: The value that people with learning difficulties place on support from others with learning difficulties, that is peer support, emerges as a theme and an argument is presented for further inclusive research in this area. (Publisher abstract)
Reducing inequalities in health and life expectancy
- Authors:
- NEVE Jane, BRIERS G.
- Journal article citation:
- Nursing Times, 112(5), 2016, pp.12-14.
- Publisher:
- Nursing Times
Many people with mental health problems or learning disabilities die early, preventable deaths, but steps can be taken to ensure their physical health needs are not overlooked. This article describes research conducted to establish the evidence base through a review of the literature and draw up priorities for action, along with the competencies mental health and learning disability nurses need to improve service users' physical healthcare. The article also refers to a training course for mental health nurses delivered in the Pennine Care Foundation Trust as an example of good practice and provides recommendations for Trusts. (Edited publisher abstract)