Guest editorial

Citation

Charnock, D. and Wright, N. (2017), "Guest editorial", The Journal of Mental Health Training, Education and Practice, Vol. 12 No. 4, pp. 213-214. https://doi.org/10.1108/JMHTEP-06-2017-0040

A gradual but significant shift has occurred in services for people with intellectual disabilities in the last half century, in part resulting in a call to mainstream health and social care provision to improve access. This call envisages services that are responsive to the specific needs of people with intellectual disability, with knowledgeable staff and appropriate resources to plan and deliver successful outcomes. Although there has been a concerted focus on change and improved access in the past 17 years, there remains much work to be done to provide appropriate services to people with intellectual disabilities who also have mental health problems. The simple response is that services must change to accommodate these individuals, with adjustments made to facilitate accurate diagnosis, treatment plans and safe discharge. However, this simplistic response can often mask the complexities and challenges of delivering care in mainstream settings to this group. These complexities and challenges require careful consideration in relation to staff skill, infrastructure to support interdisciplinary working and the provision of innovative and creative approaches to care.

This special edition aims to address some of the complexities and challenges faced in mainstream mental health services in three ways. First, to highlight the specific needs of people with intellectual disabilities and mental health problems. Second, to promote the importance of interdisciplinary working and learning in relation to mental wellbeing and intellectual disability, showcasing innovative approaches to care and finally, to offer a voice to specialists from intellectual disability practice and research to foster practical and conceptual thinking in relation to this group of service users. The six papers in this collection address the important issues for people with intellectual disabilities and offer help to the staff who support them in mainstream mental health care.

The collection begins with four articles which offer assistance to staff in their encounters with people with intellectual disabilities in mainstream mental health services. First, an article written by Standen, Clifford and Jeenkeri aims to help staff in mental health services to recognise people with intellectual disabilities in their care. The authors have set out to provide a briefing to assist staff in their assessments and continued support of this group of service users. Drawing on literature and their own experiences, the authors provide a fascinating starting point on which to build a firm knowledge base for working with individuals with an intellectual disability and mental health problem.

Moving on from the initial recognition of the person accessing services, Jones, Jeenkeri and Cutajar present a neurodevelopmental model to assist the mental health practitioner in extricating the many issues relevant to the provision of services to people with intellectual disabilities and mental health problems. In doing so, the authors provide the reader with a framework to improve understanding and assist with the management of the person.

Responding to the absence of a core competency framework in relation to capacity among mental health professionals providing care to people with intellectual disabilities, Troller, Eagleson, Weise and McKay provide an account of the development of a framework in New South Wales. The authors discuss the need for a framework to facilitate an organised approach to the needs of people with intellectual disabilities and mental health problems. The article offers motivation for the development of similar frameworks in other mental health services.

This initial group of four articles concludes with an article by Posner, Janssen and Roddam, who report on a research project on burnout in staff working in mental health services. Refocussing the reader’s attention from service delivery to the impact of service user complexity and challenge on staff, the authors’ findings uncover ideas to help improve burnout and mental toughness. Nine strategies are presented as part of the findings of the research, to provide foci for the delivery of training to mental health professionals.

The final two articles included in this special edition, present innovative approaches to the inclusion of people with intellectual disabilities in their care and in training to develop the skills and knowledge of staff working in mental health services. Using wordless books can assist practitioners to support clinical consultations with people who have an intellectual disability enabling them to reveal ideas about their lives. Holins, Carpenter, Bradley and Egerton present a review of practice focussing on the use of these books with patients. The article presents a fascinating review and insight, offering an invitation for staff to engage with this innovative and unique resource in their encounters with patients who have an intellectual disability. Most importantly the use of these books is presented as a method to facilitate reasonable adjustments for this group, to enable access to services.

For our final contribution, Attoe, Billon, Riches, Marshall-Tate, Wheildon and Cross continue the theme of improving staff competence and in turn the improvement of service provision through innovative methods. The co-production and delivery of simulation for staff training is unique, presenting an opportunity for staff to become familiar with the needs of this service user group in a safe environment. Benefits of interprofessional education are discussed with a clear conclusion regarding shared responsibility for the improvement of services.

Concluding remarks

The opportunity to edit this special edition has been both an honour and a privilege. The six articles included are part of a journey which will hopefully lead to fair and equal access for people with intellectual disabilities in receipt of mental health care in the future. Care which will be provided by staff who understand, have the necessary skills and knowledge and who can respond innovatively and creatively. The journey stretches beyond these articles into the distance with many obstacles and challenges that have still to be encountered. However, this special edition attests to the desire of specialists from the field to join with both people with intellectual disabilities and the staff who support them to find solutions through research and practice. The very act of sharing knowledge across traditional boundaries changes the very nature of our relationship and the services we provide to people with intellectual disabilities and their families.