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The purpose of the study was to examine whether there were differences in the provision of non-pharmacological interventions based on the level of intellectual disability and the presence or absence of autism. Mental health conditions are often underdiagnosed in adults with intellectual disability and do not always receive psychological interventions as recommended by the National Institute for Health and Care Excellent guidelines. To realise the national UK programme’s aim of stopping the overuse of medications in people with intellectual disability, it is important that these individuals have access to appropriate non-pharmacological interventions. The authors examined the relationship between an individual’s level of intellectual disability and the presence or absence of autism with access to relevant non-pharmacological interventions from specialist community intellectual disability services.

A cross-sectional study of adults accessing four specialist intellectual disability services in North West England in 2019.

There was a high prevalence of mental health comorbidity, even higher for autistic adults. However, a relatively small percentage of the study population was receiving psychological interventions. The most frequent non-pharmacological intervention was a positive behaviour support plan, irrespective of comorbid mental illnesses.

Not having access to psychological interventions for the treatment of mental illness could result in poor health outcomes and increasing health inequalities. The study highlights the need for developing psychological interventions, particularly for those with moderate to severe intellectual disability and for those with associated autism.

This large sample study examined the relationship between intellectual disability level and the presence of autism with accessing psychological interventions.

The purpose of this paper is to describe and critique the methodology used to develop a core competency framework for mental health professionals working with people with an intellectual disability and co-occurring mental ill health.

A multi-phase, multi-method design was used to collect qualitative and quantitative data, including a scoping survey, modified online Delphi, and consultation with multiple stakeholders. The implementation phase involved a launch forum and workshop, toolkit development, and evaluation strategy.

Results from the scoping survey and consultation process informed the development of a core competency framework with 11 domains. An accompanying toolkit was also developed with practical guidance to assist with the implementation of the core competencies. In total, 93 professionals attended the launch forum, and the framework has been downloaded 998 times during the first year it has been available.

Detailed information specific to each profession cannot be included when a whole of workforce approach is used. The ways in which to use the framework in conjunction with other core competency frameworks is discussed.

This framework can be utilised by mental health workers including clinicians, managers, service developers, and educators, from multiple professional backgrounds. The approach taken can also be used by others to develop similar frameworks.

This is the first core competency framework, to the authors’ knowledge, specifically designed for public mental health professionals from varied backgrounds working with people with an intellectual disability. Consulting with multiple stakeholders, not just experts, elicited new information that may otherwise have been overlooked.

Transitions for young people with intellectual disabilities have received much attention from researchers. Little is known, however, about how mental health services link with existing transition partnerships and what the potential service gaps are for young people with intellectual disabilities. Eight mental health professionals in three local authorities in Wales were interviewed to sketch potential research themes in this area. Our findings revealed a remarkable lack of engagement of mental health professionals with transition partnerships for young people with intellectual disabilities, and significant service gaps. The insufficient integration of mental health services in transition planning may contribute to disruptive transitions for young people with intellectual disabilities and their carers. Further research should examine how best to involve mental health services in transition partnerships for young people.

The purpose of this paper is to identify approaches that mental health clinicians, working in intellectual disability services, can adopt to ensure the spiritual needs of their service users are met.

A narrative literature review examining original research, expert opinion pieces and book chapters was undertaken. To broaden the perspective of the paper, publications from different academic areas were reviewed including intellectual disabilities, mental health, neurodevelopmental disorders, general health and spirituality literature.

The main principles of spiritual assessment tools from the general health literature can be applied to this group. However, the literature would suggest that certain approaches are of particular importance in intellectual disabilities mental health including advocating for service users to attend the religious services they wish to and working collaboratively with families and carers when addressing spiritual issues.

The question of how to meet the spiritual needs of people with autism and severe intellectual disability is a neglected research area. Research examining the spiritual needs of service users with intellectual disabilities, on mental health inpatient units, is also needed as well as a review of whether spiritual needs are being met in current person-centred care plans.

No published literature review was identified that specifically addressed the question of how mental health clinicians should approach the spiritual needs of their service users.

The purpose of this study is to analyse the characteristics of all the referrals to the forensic MHIDD service over the past five years and to compare these characteristics to the cohort of service users attending the three general MHID services based in Dublin which are Service 1, Service 2 and Service 3.

This is a cross-sectional study of adults attending the three generic MHID services and the national forensic MHIDD service. The medical files of service users attending the MHID services were reviewed, and data such as age, gender, level of intellectual disability and psychiatric diagnoses were extracted and compiled into a database. The forensic MHIDD service has since its inception maintained a database of all referrals received and reviewed. The characteristics data needed were extracted from the forensic MHIDD database. All these data were then analysed using the Statistical Package for Social Sciences (SPSS).

The majority of the three MHID service users were in the moderate to profound range of intellectual disability, while the majority of the cases assessed by forensic MHIDD had normal IQ, borderline IQ and mild intellectual disability with 66.1%. The prevalence of neurodevelopmental disorder, schizophrenia and emotionally unstable personality disorder in the forensic MHIDD is comparable to the three MHID services. The prevalence of depression, bipolar affective disorder (BPAD), anxiety disorder and obsessive-compulsive disorder (OCD) is higher in the three MHID services than in the forensic MHIDD service.

The FHMIDD received referrals at a greater level of overall ability, with two-thirds of the service users having mild intellectual disability to normal IQ. The prevalence of neurodevelopmental disorder such as ASD and schizophrenia is comparable between the forensic MHIDD and the three MHID services. There is a higher prevalence of depression, BPAD, anxiety disorder and OCD in the three MHID services as compared to the forensic MHIDD service.

Services for people with intellectual disabilities would be barely recognisable to clinicians working half a century ago. Two forces in particular stand out as driving the changes that we see today. The first accompanied the closure of the once popular institution‐like hospitals as part of a general reorientation within psychiatry as a whole from the asylum to the community. The second is the push towards incorporating people with intellectual disabilities in ‘mainstream’ services, the principle of ‘normalisation’ that sits at the heart of health and social policy in the UK for this group of people. This article is a reflection on the current status of mental health services for people with intellectual disabilities against this historical and philosophical backdrop and the arguments for their continued existence as a separate specialist entity within the field of psychiatry.

Examining the education and training needs of forensic nurses is paramount as services move from the older institutions to new care settings. The purpose of this study was to identify Irish Forensic nurses perceived deficits in their knowledge and skills to assist them to provide effective seamless care for individuals with an intellectual disability within their forensic mental health service, so that appropriate training could be provided.

Training needs analysis (TNA) procedures are used as a way of establishing the continuing processional development of staff, as they seek to identify the gaps between the knowledge and skills of an individual and the need for further training. A training needs tool developed by Hicks and Hennessy (2011) was used and completed by nurses working in an Irish forensic mental health service. A total of 140 surveys were circulated and 74 were completed (51 per cent response).

The top priority training needs identified were for additional training in research and audit and in the use of technology. Other self-identified training needs included additional training in behavioural management for challenging behaviour, understanding mental health and intellectual disability and dual diagnosis, training in enhancing communication skills and how to work with patients who have an intellectual disability patients specific training on autistic spectrum disorders and a guide and template for advance individual care planning and for caring for the physical health needs and promoting the physical health needs of these patients.

Despite there being a vast range of training issues identified, the majority of nurses appear to have a clear idea of their training needs to ensure the provision of seamless care for individuals with an intellectual disability within a forensic mental health setting. This TNA has identified the specific needs of nursing staff working at different positions across the interface of intellectual disability and forensic mental health care.

It is widely acknowledged that people with intellectual disabilities are highly likely to experience mental health problems, but that support workers' knowledge and skill in this area is sometimes lacking. There is little research explicitly exploring knowledge about the mental health of older people with intellectual disabilities and the purpose of this paper is to attempt to fill this gap.

In total, 14 support workers completed a questionnaire in which three vignettes presented progressively worsening indicators of dementia in an older person with intellectual disabilities. Participants explained what they thought was happening and what action they would take. Data were analysed using Braun and Clarke's framework.

Few participants had undertaken any mental health training, and only one in relation to older people. They were generally poor at judging early and intermediate indicators of dementia, but were able to identify more overt later signs. However, they believed these advanced indicators to be the onset of dementia. Nonetheless, they would generally take appropriate action, such as observation and referral. Abuse was often considered as a causal factor.

The most significant implication is the need for training in the mental health needs of older people and in particular, the general and specific indicators and expected trajectory of dementia in this population.

The study adds to the limited research on staff knowledge about older people with intellectual disabilities and dementia, using a novel methodology.

The purpose of this paper is to describe key policy and practice issues regarding a significant subgroup of people with intellectual disability – those with offending behaviour being treated in forensic hospitals.

The reasons why psychiatrists continue to be involved in the treatment of people with intellectual disability and mental health or behavioural problems and the factors that may lead to patients needing hospital admission are examined. Using two illustrative examples, three key questions – containment vs treatment, hospital care vs conditional discharge and hospital treatment vs using deprivation of liberty safeguards usage in the community are explored.

Patients with intellectual disability, mental health problems and offending behaviours who are treated within forensic inpatient units tend to have long lengths of stay. The key variable that mediates this length of stay is the risk that they pose to themselves or others. Clinicians work within the framework of mental health law and have to be mindful that pragmatic solutions to hasten discharge into the community may not fall within the law.

This paper makes practical suggestions for the future on how to best integrate hospital and community care for people with intellectual disability, mental health and offending behaviours.

People with an intellectual disability are at an increased risk of developing a mental illness. An estimated 50 per cent develop a significant psychiatric problem at some point in their lives. Since the shifting trend to treat and manage individuals in the community setting, there are concerns over the lack of guidance of how intellectual disability mental health services in the community should be organised. This paper aims to address this issue.

Details of all new referrals made to the mental health of intellectual disability team in Dartford, Kent over a 12‐month period were collated and a questionnaire was used to gather retrospective data of each referral pathway.

There were 50 patients referred in total, with the primary source being GPs (58 per cent). In total, 40 per cent of all referrals were considered to be inappropriate for the mental health of intellectual disability team and the majority of these originated from the adult mental health and child and adolescent mental health service teams.

These findings identify areas of focus for closer liaison with colleagues to improve the quality of referrals and to reduce the demands placed on our service.