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This article explores the nature of the classifications of learning disabilities as promulgated in the diagnostic manuals. By leaving aside all doubts and controversies that surround the concept and measurement of intellectual functioning, weaknesses are exposed from within those manuals' own frames of reference. The difficulties arising from using the international sub‐classifications of learning disabilities when the national classifications should apply are discussed.

Traditionally, participation in the local community has been considered a crucial component of community living for people with learning disabilities. Highlighted in Valuing People (DH, 2001) and in Valuing People Now (DH, 2007), this concept ‐ now appearing as ‘inclusion’ ‐ has retained its prominence, and is an important area for service development and monitoring. Monitoring of community activities was undertaken pre‐ and post‐closure of two small day service facilities. The findings indicate that for this group of people (generally older with higher support needs) the closure of the day service facilities did not, overall, result in a significant increase in community activities. The availability of the time that the person had previously spent in specialist day services was not, by and large, used to develop social inclusion. Even though, for some individuals, some gains were recorded, overall these gains were considered a poor return for the hours released from the closure of the day service facilities.

Traditionally, participation in the local community has been considered a crucial component of community living for people with learning disabilities. As one of the key principles in Valuing People (DH, 2001), this concept ‐ now appearing as ‘inclusion’ ‐ has retained its prominence, and is an important area for service development and monitoring. In 1995, following the closure of a large long‐stay hospital, a survey of the community activities of a group of people with learning disabilities living in the community was undertaken. The study was repeated in 2005, for 18 people. For those individuals there was no difference in the frequency of community activities over the 10‐year period. The findings indicate that, for this group of people (people with more severe learning disabilities, requiring 24‐hour support), any aspirations that the frequency of participation in community activities would increase over time have not been met. This is in spite of the re‐focusing on ‘inclusion’ ‐ with the publication of the White Paper, Valuing People ‐ during this period.

This paper considers the applicability of the Improving Access to Psychological Therapies (IAPT) initiative in meeting the mental health needs of people with learning disabilities.

The author considers the nature of the IAPT service, the potential benefits, the potential barriers and how local services could be better adapted to meet the needs of people with learning disabilities.

Although the IAPT service is well established for the mainstream population, for people with learning disabilities there are deficits and barriers at many levels. Increased attention should be given to removing barriers to access; the provision of “reasonable adjustments” in treatment; and to the monitoring of uptake and outcomes. Even with these issues addressed, the service will not meet the mental health needs of all people with learning disabilities.

Whilst acknowledging the potential value of IAPT, without specific consideration being given, mainstream approaches to mental health will not be applicable to all people with learning disabilities: “reasonable adjustments” need to be made not only at the direct clinical level but also throughout the system, from service commissioning to outcomes.

In the context of a staff development programme, the relationships between work‐related stress, staff support and job satisfaction were explored among staff groups in two residential assessment and treatment facilities for people with learning disabilities and challenging behaviour. Although overall support was relatively high for both formal and informal supports, only the informal supports from colleagues were negatively correlated with ratings of work‐related stress. Work‐related stress and job satisfaction were shown to be independent factors, and thus levels of stress could not be inferred from overall ratings of job satisfaction, or vice versa. The study identified a potentially vulnerable group of staff who reported relatively high job satisfaction but also some degree of stress.