Exploration of the dynamic barriers to adults with intellectual disabilities accessing mainstream mental health services

Abstract

Purpose – The purpose of this paper is to investigate the experiences of psychologists in considering the barriers to people with intellectual disabilities being able to access mainstream mental health services. Design/methodology/approach – The information relating to participant experiences was gathered by conducting two focus groups: one with psychologists working in the adult mental health service and the second with psychologists working in the learning disability service. A thematic analysis was used to determine the main themes from each of the focus groups. Findings – The overarching themes for the psychologists in the adult mental health service related to: service restrictions; confidence in their ability/skills; and resistance to change. The overarching themes for the psychologists in the learning disability service reflected: future thinking; protection; pessimism; and clarification around mental health and learning disability. Originality/value – The discussion includes consideration of the dynamic positions of the two services and recommendations for an integrated system of working.

Access to primary and community health-care services for people 16 years and over with intellectual disabilities: a mapping and targeted systematic review

“…The studies were mostly weak in design and some date back to the early 2000s and are unlikely to represent current practice. Topics highlighted in recent studies include the need for longer appointments and continuity of care, 53 the roles of mainstream versus specialist services 54,61 and the continuing need for 'reasonable adjustments'. 65…”

“…Of these, six dealt with a range of primary care services, 50,55,58,62,66,67 six dealt with with general practice, [51][52][53]57,60,70 five dealt with cancer screening, 59,63,68,69,72 two dealt with dental services, 56,64 two dealt with mental health services, 54,61 one dealt with diabetic retinopathy screening 65 and one dealt with sexual health. 71 The majority of included studies used a cross-sectional (e.g.…”

“…This was true for cervical screening 72 and mental health services. 61 In a study of sexual health services, young adults with ID in Scotland expressed a preference for accessing mainstream services and felt that staff in these services should be able to meet their needs. 71 In relation to cancer screening generally, Rees et al 68 reported that community staff working with people with ID had low awareness of some national screening programmes and were unsure of age limits and recommended intervals for screening.…”

“…McNally et al 61 reported that lack of resources limits access by people with ID to mainstream mental health services and it is important that services do not offer 'false hopes' about what they can provide. In another study, dental services were reported to not be available at suitable times, again limiting access.…”

Services for people with intellectual disabilities and mental health problems in Singapore: perspectives from mainstream mental health professionals

“…Qualitative research addressing the experiences of psychologists and psychiatrists working in generic mental health services has revealed a self-confessed lack of skill and experience which contributes to low self confidence in their ability to provide mental health services and care to people with intellectual disabilities (Lunsky et al. 2008 , McNally and McMurray 2015 , Rose et al. 2007 ).…”