Clinical services for people with intellectual disabilities and psychiatric or severe behaviour disorders

Treatment Models for Treating Patients with Combined Mental Illness and Developmental Disability

“…These individuals appear particularly sensitive to a particular treatment strategy that lacks statistically significant effects in large group designed studies. Single case designs may be helpful, especially when the cohort is a highly heterogeneous population-outcome studies are confounded by not only neurobiological diversity but also subtle effects of ethnicity, culture, family structure, language/ communication barriers and socio-economic differences [12,[21][22][23][24].…”

“…In short, the evolving nature of provider driven service delivery and the need for integrating specialized services is exposing problems within different organizational cultures. On occasion confusion arises based on problems of interfacing record-keeping systems, mismatched provider service packages, inadequate communication between providers and fragmentation of care [22].…”

“…Recognition of sleep disorders by the psychiatrists can prompt referral for sleep studies and initiation of appropriate medical care [35][36][37][38][39]. In a larger sense, the psychiatrist can also provide cross-disciplinary training and supervision for treatment staff, especially in the area of mental disorders and psychopharmacology [22,40,41]. Unfortunately, collaboration can run aground in settings where there is a shortage of well trained direct care staff available to implement the plan of care and adversely affect the quality of care [34,42,43].…”

“…Because of this shortfall, many providers struggle to maintain community placement and meet the more demanding needs of the dually diagnosed. In many communities individuals are literally ''bounced'' from one system to another, ''fall through the cracks,'' or enter the revolving door or admissions to mental health or developmental centers [22].…”

Mental health services for people with intellectual disability: a conceptual framework

“…In the USA and other countries where there is an overall lack of specialist services for people with intellectual disabilities, there is evidence of adverse consequences ( Davidson et al 1999 ; Jacobson 1998). A prevailing view is that people with intellectual disabilities and concomitant psychiatric disorders have often been under‐served or inappropriately treated because of inter‐organizational barriers, leading to unnecessary hospitalization and lengthy delays in community placement.…”