Annotation: New research into general psychiatric services for adults with intellectual disability and mental illness

Abstract

Background There are a variety of models for the mental health care of adults with comorbid intellectual disability (ID) and mental illness. There has been a long-running debate as to whether this should be provided by general psychiatric or specialised ID services. A previous review concluded that there was no clear evidence to support either model with research being often of a poor quality, lacking replication, and outcome measures were often inappropriate or varied between studies. This review aims assess differences in outcome for patients with ID and mental disorders treated in general or specialised ID mental health services. Method A literature review was conducted using electronic databases and websites of ID and mental health organisations to locate all references where people with ID receive mental health care in general psychiatric services from 2003. No metaanalysis was attempted because of the divergent nature of the studies. Results People with ID (especially severe ID) have reduced access to general psychiatric services. General psychiatric inpatient care is unpopular especially with carers but can be improved by pro-

A curriculum on care for people with disabilities: Effects on medical student self-reported attitudes and comfort level

“…9,31 In training medical students, this is particularly important since negative biases have been shown to adversely affect medical care of people with disabilities. 11,12,32,33 By administering a pre-and post-attitudinal and comfort level survey, we sought to document objective quantitative effects on student attitudes by examining changes in the class which experienced the curriculum, and in a control class which did not experience the curriculum. We also evaluated qualitative feedback by students about individual elements of the curriculum, which indicates that the curriculum did have a positive impact on students' experience working with people with disabilities.…”

An examination of drug and alcohol services engaging with complex needs in New South Wales, Australia

“…On the one hand, for example, Chaplin (2009) found that in the first instance, people with intellectual disability, especially those with more complex disability, had reduced access to general psychiatric services. Chaplin (2009) also found that accumulating evidence suggests that provision of general psychiatric services may not be effective for people with intellectual disability without additional supports such as outreach from specialised community intellectual disability services. Largely however, Chaplin found that further investigation by way of large-scale qualitative studies was warranted in order to assess relative effectiveness of mainstream versus specialised mental health services for people with intellectual disability (2009, p. 197).…”

“…An earlier study (Hall, Parkes, Samuels, & Hassiotis, 2006), referenced by Chaplin (2009), found that, ''Working with mainstream mental health services and across health and social service boundaries delivers effective mental health care for people with intellectual disabilities'' (Hall et al, 2006, p. 598). Hall et al (2006) studied the Mental Health Service for People with Learning Disabilities in North London.…”

“…It is possible that this finding could also relate to mainstream residential drug and alcohol rehabilitation settings. On a broader level too, the experience of this service may point to Chaplin's (2009) finding that mainstream services alone, without additional supports, may not necessarily meet the needs of individuals with cognitive impairment.…”

“…Remarkably however, the literature around specific assessments for cognitive impairment in this cohort is relatively scant. As discussed by Chaplin (2009), studies investigating appropriate assessment tools and interventions in a client group with cognitive impairment of one form or another are too diverse and contradictory to draw any firm conclusions. Chaplin (2009) advocated wide ranging qualitative studies as a good starting point for further investigation.…”