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People with intellectual disabilities accessing mainstream mental health services: some facts, features and professional considerations
- Authors:
- STANDEN Penelope Jane, CLIFFORD Adam, JEENKERI Kiran
- Journal article citation:
- Journal of Mental Health Training Education and Practice, 12(4), 2017, pp.215-223.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to provide information for non-specialists on identifying the characteristics, assessment and support needs of people with intellectual disabilities (ID) accessing mainstream services. Design/methodology/approach: A review of relevant policy and research literature is supplemented with observations from the authors’ own experience of working in mental health services for people with ID. Findings: With change in provision of services the likelihood of mainstream staff encountering someone with ID will increase. However, information on whether a person has ID or their level of ID is not always available to professionals in acute mental health services meeting an individual for the first time. Reliance on observational and interview-based assessments can leave people with ID vulnerable to a range of over- and under-diagnosis issues. This is as a result of difficulties with communication and emotional introspection, psychosocial masking, suggestibility, confabulation and acquiescence. For people with poor communication, carers will be the primary source of information and their contribution has to be taken into account. Practical implications: Knowing or suspecting an individual has ID allows staff to take into account the various assessment, diagnosis and formulation issues that complicate a valid and reliable understanding of their mental health needs. Awareness about an individual’s ID also allows professionals to be vigilant to their own biases, where issues of diagnostic overshadowing or cognitive disintegration may be important considerations. However, understanding some of the practical and conceptual issues should ensure a cautious and critical approach to diagnosing, formulating and addressing this population’s mental health needs. Originality/value: This synthesis of a review of the literature and observations from the authors’ experience of working in mental health services for people with ID provides an informed and practical briefing for those encountering people with ID accessing mainstream services. (Publisher abstract)
Psychiatry and intellectual disabilities: navigating complexity and context
- Authors:
- JONES Jo, JEENKERI Kiran, CUTAJAR Peter
- Journal article citation:
- Journal of Mental Health Training Education and Practice, 12(4), 2017, pp.224-236.
- Publisher:
- Emerald
Purpose: The paper is a review, for the general adult mental health practitioner, of the issues to consider when managing a mental health presentation of a person with intellectual disability (PWID). The paper aims to discuss these issues. Design/methodology/approach: A neurodevelopmental model is outlined to assist practitioners in unravelling the wide range of potential factors relevant to intellectual disabilities (IDs). This includes an emphasis on complexity and interdisciplinary formulation within an individual’s context, and implications of the current policy changes. Findings: In practice, managing the mental health of PWID can be challenging within usual mainstream services; there is more to consider than is usual for the general population. Originality/value: The paper provides general mental health practitioners with a framework for a greater depth of understanding of the issues involved in the management of people with intellectual disability (ID). This includes discussion of the current policy context in ID, and some of its limitations. (Publisher abstract)