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

Moss, Steve; Bouras, Nick; Holt, Geraldine

doi:10.1046/j.1365-2788.2000.00283.x

Cited by 47 publications

(41 citation statements)

References 26 publications

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“…9,29 Further complicating the matter, it has even been noted that the effects of prolonged institutional care are difficult to distinguish from symptoms of schizophrenia among those with severe MR. 30 Symptoms of mental health disorders have often been seen as characteristic of MR. 7,19 While today it is recognized that mental health conditions exist in individuals with MR and are separate from MR, 18,19 distinguishing symptoms of mental health conditions from those of MR can actually be quite challenging. 9,18,[31][32][33][34][35][36][37] The presence of MR, for instance, often diminishes the diagnostic significance of behavior that would otherwise be indicative of a mental health disorder. Consequently, symptoms of a mental health disorder are often attributed to the MR, rather than evaluated as a potentially separate condition.…”

Section: Risk For Mental Health Disorders Among Those With Mrmentioning

confidence: 99%

“…Cognitive disintegration, for example, is often difficult to distinguish from obsessive-compulsive disorder (OCD), a diagnosable mental health condition. Diagnosis of OCD is even further complicated by the fact that patients with severe MR are often nonverbal, so that the diagnosis of OCD depends more heavily on a combination of caregivers' abilities to identify symptoms and clinicians' observations 18,32,37 than on patients' accounts.…”

Section: Risk For Mental Health Disorders Among Those With Mrmentioning

confidence: 99%

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Mental Health Disorders among Individuals with Mental Retardation: Challenges to Accurate Prevalence Estimates

et al. 2004

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SYNOPSISObjectives. The objectives of this literature review were to assess current challenges to estimating the prevalence of mental health disorders among individuals with mental retardation (MR) and to develop recommendations to improve such estimates for this population.Methods. The authors identified 200 peer-reviewed articles, book chapters, government documents, or reports from national and international organizations on the mental health status of people with MR. Based on the study's inclusion criteria, 52 articles were included in the review.Results. Available data reveal inconsistent estimates of the prevalence of mental health disorders among those with MR, but suggest that some mental health conditions are more common among these individuals than in the general population. Two main challenges to identifying accurate prevalence estimates were found: (1) health care providers have difficulty diagnosing mental health conditions among individuals with MR; and (2) methodological limitations of previous research inhibit confidence in study results.Conclusions. Accurate prevalence estimates are necessary to ensure the availability of appropriate treatment services. To this end, health care providers should receive more training regarding the mental health treatment of individuals with MR. Further, government officials should discuss mechanisms of collecting nationally representative data, and the research community should utilize consistent methods with representative samples when studying mental health conditions in this population.

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Section: Risk For Mental Health Disorders Among Those With Mrmentioning

confidence: 99%

Section: Risk For Mental Health Disorders Among Those With Mrmentioning

confidence: 99%

Mental Health Disorders among Individuals with Mental Retardation: Challenges to Accurate Prevalence Estimates

et al. 2004

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“…To date there has been little systematic investigation of both service models and a lack of empirical research comparing different settings for in-patient psychiatric care for this group (Allen & Felce, 1999;Moss, Bouras, & Holt, 2000;Alexander, Piachaud, & Singh, 2001). Furthermore, the views of psychiatric in-patients with intellectual disabilities have received very little attention.…”

Section: Introductionmentioning

confidence: 99%

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

Longo

Scior

2004

Journal of Mental Health

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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.

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“…Current knowledge is the extent of existing information regarding ID and CB, and the provision of quality services to this cohort. Limitations in current knowledge have been identified in the areas of: prevention; assessment; effectiveness of systems, treatments and practices; best practice; management systems and processes conducive to quality outcomes; utilisation of technologies; and evaluation methodology (Fixsen et al, 2005;Forrester-Jones et al, 2006;Moss, Bouras, & Holt, 2000;Townsend, 2011). Thus, current knowledge can limit/enable quality provision of services.…”

Section: Staff Attitudesmentioning

confidence: 99%

“…prevention; assessment; effectiveness of systems, treatments and practices; best practice; management systems and processes conducive to quality outcomes; utilisation of technologies; and, evaluation methodology (Fixsen et al, 2005;Forrester-Jones et al, 2006;Moss et al, 2000;Townsend, 2011). Through consultation with the authority on departmental process and procedures, this has been extended to include clinical expertise.…”

Section: Current Knowledge and Clinical Expertise Current Knowledge mentioning

confidence: 99%

A conceptual model of quality service provision for people with intellectual disability and challenging behaviours: Enhancement and enrichment through service user and other stakeholder consultation

Gatfield¹

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People with intellectual disability and challenging behaviour are one of the most disenfranchised groups in society. How they are supported through services has a primary role in changing this outcome. While legislation provides frameworks for quality service provision for people with disabilities, they do not identify the mechanisms specific to the cohort that can address this disenfranchisement. As such, it is paramount to develop an understanding of quality service provision specific to those with intellectual disability and challenging behaviour.To identify the factors required for quality service provision for people with ID and CB, a three-stage design incorporating participants from various stakeholder groups (n=7) was undertaken. Study one involved data collection from CEOs and managers (n=55) of service provider agencies using a Delphi study, and clinicians and senior practitioners (n=85) using survey methods. Study two incorporated interviews conducted with families/carers of service users (n=11), advocates (n=10), support workers (n=13) and supervisors (n=11) who had provided services to the cohort, complemented by survey data (n=102). Study three involved data collection with service users with intellectual disability and challenging behaviour (n=14) through focus groups.The results of this research led to the identification of processes and practices associated with and impacting on quality service provision that were not identified through the literature review. Further, it identified agents that are formative to the production of quality services.The outcome of this research is a model of quality service provision for the cohort that conceptualises quality as a continuous process and includes factors across sociopolitical systems that are formative to, and impacting on, quality service provision. The developed model has significant implications for service provider agencies, service user consultation, government, substitute decision making, and the National Disability Insurance Scheme.

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

Cited by 47 publications

References 26 publications

Mental Health Disorders among Individuals with Mental Retardation: Challenges to Accurate Prevalence Estimates

Mental Health Disorders among Individuals with Mental Retardation: Challenges to Accurate Prevalence Estimates

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

A conceptual model of quality service provision for people with intellectual disability and challenging behaviours: Enhancement and enrichment through service user and other stakeholder consultation

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