In-patient psychiatric care for individuals with intellectual disabilities: the service users' and carers' perspectives

Abstract

Background: Little is known about the experiences of individuals with intellectual disabilities and additional mental health problems who are admitted for inpatient psychiatric care. In the UK such care is delivered in both generic psychiatric and specialised treatment settings. Aims: The present study explored service users' and carers' views on in-patient psychiatric treatment received across these two settings. Method: Thirty service users and wherever possible their main carers were interviewed about their views on the psychiatric admission, treatment and discharge process. Data was gathered during semistructured, one-to-one interviews. Results: Both service users and carers identified positive and negative aspects of the psychiatric admission. For service users lack of control and information, support from staff, or conversely its absence emerged as key themes. For carers concerns about service users' vulnerability, negative staff attitudes and opportunities for involvement emerged as key themes. The accounts of both groups regarding generic psychiatric settings were predominantly negative. In contrast, specialized settings were frequently described as providing a pleasant environment, supportive and caring staff, good information sharing and satisfactory discharge arrangements. Conclusions: Important areas for service improvements are highlighted. Implications in particular for generic settings are considered. Declaration of Interest: None.

Restraint and Seclusion in Services for People with Mental Health Problems and Learning Disabilities: A Literature Review

“…High rates of physical violence have been found in populations with learning disabilities in community settings (Allen 2000) and forensic settings (McMillan et al 2004). Psychiatric services for this population are provided by both generic (adult mental health) and specialised (people with learning disabilities) settings, though the latter are typically considered more appropriate and positive from the perspective of users and carers (Longo & Scior 2004).…”

A Social Constructionist Appreciation of the mental health inpatient nursing care for people with intellectual disability

“…However what evidence is available suggests it is higher than in the general population and with some suggesting it may be as high as 40%, approximately double the non-intellectually disabled population . Whatever the prevalence, there is now widespread agreement that people with ID have increased risk factors for developing mental illness Longo & Scior, 2004;. This increased vulnerability is understandable in light of the many contextual biological, social and psychological impacts that may be evident for this group (See Tables 2.1 -2.3 adapted from Deb, Matthews, Holt and Bouras 2001 pp 8 -10).…”

“…Equally the health professional may not recognise the importance of consulting the carer (Wallace & Beange, 2008). The study mentioned previously by Longo and Scior (2004) and Scior and Longo (2005) which sought the experiences of both people with ID and carers to compare their experiences of admission of the person with ID for mental health care, focussed on admission, treatment, previous experiences and admission processes. They found that carers wished to be more involved and consulted with more frequently.…”

“…While there have been a small number of studies where the carer was consulted to gauge the needs of people with dual disability it is now recognised and recommended that it is more important to obtain views of both people with ID and their carers (Johnson, Mason, & Withers, 2003;Nadarajah, Roy, Harris, & Corbett, 1995 (Longo & Scior, 2004;Raghaven & Patel, 2005). The majority of health professionals that currently work with this group in New Zealand continue to be nurses.…”

“…A qualitative study was undertaken using semi-structured interviews with 29 people with ID and mental health issues and 20 support carers to understand and compare their experiences of admission to either a generic psychiatric ward or a specialist dual diagnosis inpatient setting (Longo & Scior, 2004;Scior & Longo, 2005). The focus of the interview with the people with ID and mental illness, covered experience of treatment, admission, carer's involvement, relationship with staff and other patients, the environment, discharge, and follow up.…”